Will be used for an emergency contact number. Please make sure this is a phone number that is monitored.
Will be used for communication from the team regarding team events and information.
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If no, please enter participants address next.
Select the grade this participant will be entering in the fall.
This question helps enter the rider in the correct team within the NICA registration system and planning for team growth.
if not applicable, type "none"
if not applicable, type "none." Participants must be able to store and administer medications independently per NICA guidelines.
Riders who are fully registered with NICA, and who register for races by July 20 will have their first name and last initial printed on their number plate. If desired, enter a shortened version of your first name here. Name is limited to 20 characters.
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Parent or Guardian’s Consent, Representations and Agreements (including Indemnification Agreement) I, the person signing, represent and agree that: (1) I have the legal right to enter into the above participation agreement on behalf of the minor athlete or volunteer named above (the “Participant”) (2) I hereby enter into the above Participation Agreement on behalf of myself and on behalf of the participant; (3) I agree to HOLD HARMLESS, DEFEND and INDEMNIFY the Released Parties from any and all claims of mine – and any spouse, heir, representative or assign of mine – arising from loss or damages (be it property or personal-injury related) due to the Participant’s attendance at or participation in the Events, I hereby WAIVE, RELEASE and DISCHARGE those claims hereby, including all claims for NEGLIGENCE, except that I do not waive, release or discharge any claims for harm caused by a Released Party intentionally or recklessly.