2016 Registration Form

Sea Gull Century • Saturday, October 8, 2016 • Sign up today!
ENTERTAINMENT, FOOD & FAMILY FUN
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Sea Gull Century Events:
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Friday Pre-Ride Free Reception
Perdue Lawn • 4-7 p.m.
Saturday Lawn Party with live music
Finishing area • Noon-6 p.m.
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Meals at the Commons:
SU’s award-winning dining facility features
all-you-care-to-eat fare. Pre-paid tickets
are available
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EXPO AREA
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Friday Tour de Commons Dinner
4:30-8:30 p.m. $12
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Saturday Gear-Up Hi-Carb Breakfast
6:30-8:30 a.m. $8
Saturday No Helmet Required Dinner Buffet
4:30-8:30 p.m. $12
Sunday Happy Trails Breakfast
8-10 a.m. $8
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Vendor merchandise and Sea Gull Century
gear on sale in Maggs Center, Friday
3-8 p.m. and Saturday 7 a.m.-7 p.m.
LOCAL ATTRACTIONS:
SU’s Ward Museum of Wildfowl Art – Home
to an expansive collection and exciting exhibits.
Free with rider number.
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Salisbury Zoo and Park – Free admission to the
zoo and a great playground for the kids.
Enjoy a Day at the Beach – Just 30 miles to
the Atlantic Ocean at Fenwick Island, DE, or
Ocean City, MD.
Historical Small Towns – Berlin, Pocomoke,
Princess Anne and Snow Hill.
Good Beer Festival – Sample over 100 craft
brews at Wicomico County’s Good Beer
Festival, October 8 and 9 at Pemberton
Historical Park in Salisbury. For more
information, visit: www.GoodBeerFestival.org
TOUR POLICY
There is no rain date; we ride rain or shine. In
case of severe weather, Sea Gull Century
reserves the right to cancel/alter/modify the
tour for safety concerns. In any case, we do not
refund tour entry fees or transfer registrations to
another tour year. In the unlikely case a tour is
canceled, you may claim your registration fee as
a tax-deductible donation.
All funds raised through the Sea Gull
Century tour supports Salisbury University and
the local community.
CHARITABLE EFFORTS
In Honor of Rob Schultheis: This year’s Century
honors the late Robert Schultheis, a 2000 SU graduate,
past rider and two-term president of the SU Alumni
Association Board of Directors, who, in 2013, was
recognized with its Alumni Leadership Award for his
volunteerism. Many cyclists will be riding to help fund the
Robert T. Schultheis Scholarship, established by the Alumni
Association in his memory.
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Habitat for Humanity: Over the years, SGC riders
have contributed more than $130,000 to build Habitat
for Humanity houses in Wicomico County. Thank you for
your gifts that helped make the American dream of
homeownership possible.
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Team Women Supporting Women: Join Team
WSW and receive a special jersey for riding with Women
Supporting Women, a local non-profit agency that provides
breast cancer awareness, education and support. Whether
you’re a novice or seasoned cyclist, there is a place for
men and women on Team WSW! For more information:
410-548-7880 or www.womensupportingwomen.org.
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SU Scholarships and Grants: A portion of proceeds
over and above Century ride expenses go toward
scholarships and grants at SU. Annually, SGC awards
12 scholarships and 15 faculty grants. See your
registration form to make a donation.
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Local Non-Profits: Each year, SGC proceeds
benefit dozens of non-profit organizations, such as
the Read Green Program, Wicomico Health
Department, Ocean City Lioness Club, Powellville Fire
Department Ladies’ Auxiliary, Helping Hands of
Beaver Dam, local elementary schools, Salisbury
Zoo, American Red Cross, Big Brothers Big Sisters,
Relay For Life and the League of American Bicyclists.
Optional Rides - Friday/Sunday • Helmets Are Required • No Saturday Registration
Two ways to register for the 2016 ride:
1. Online Registration: Register online at www.seagullcentury.org by noon September 22.
2. Mail In Registration: Please fill out the form below completely by September 30.
EVERYONE
MUST
REGISTER!
FIRST
Exp. Date _____________________ Signature ____________________________________
(Required for charge purchases)
MIDDLE
*This charge will appear as Salisbury University Foundation, Inc./SU Foundation, Inc. on your statement.
ADDRESS
CITY
STATE
PHONE (DAY)
PHONE (EVENING)
E-MAIL ADDRESS
S
Circle T-shirt Size:
ZIP
M
L
XL
AGE
XXL
(Hanes Beefy-T long-sleeve cotton)
o Male o Female
o Assateague Century (100 miles) o Snow Hill Century (100 miles) o Princess Anne Metric (65 mile)
Are you a Salisbury University: o Employee o Alum o Parent
Registration Fees & Optional Costs/Person
x Number
=
Card number
o MasterCard o Visa
Three-digit security number (on back of card)
(Duplicate for extra forms if needed)
LAST NAME
Credit Card Purchases*: Please complete the following information:
Total
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Registration Fee (includes Friday Reception, . . . . . . . . . . . . . . .$75 thru 9/1 (noon) . . . _______
. . . . . . . . = . . . . . _______
rest stop refreshments, Saturday Lawn Party
1
entertainment, Century T-shirt and more ...) . . . . . . . . . . . . . .$90 after 9/1 (noon) . . . _______
. . . . . . . . = . . . . . _______
Friday Tour de Commons Dinner at SU . . . . . . . . . . . . . . . . . . . .$12 . . . . . . . . . . . . . . . . _______ . . . . . . . . = . . . . . _______
Saturday Gear-Up Hi-Carb Breakfast at SU . . . . . . . . . . . . . . . . .$8 . . . . . . . . . . . . . . . . . _______ . . . . . . . . = . . . . . _______
Saturday No Helmet Required Dinner Buffet at SU . . . . . . . . . . .$12 . . . . . . . . . . . . . . . . _______ . . . . . . . . = . . . . . _______
Sunday Happy Trails Breakfast at SU . . . . . . . . . . . . . . . . . . . . .$8 . . . . . . . . . . . . . . . . . _______ . . . . . . . . = . . . . . _______
Sunday Crab Feast at The Red Roost . . . . . . . . . . . . . . . . . . . . . .$30 . . . . . . . . . . . . . . . . _______ . . . . . . . . = . . . . . _______
Raffle Entry for New Belgium Custom Bike,
Evolution Craft Brewery Gift Basket . . . . . . . . . . . . . . . . . . . .$10 . . . . . . . . . . . . . . . . _______ . . . . . . . . = . . . . . _______
2015 Jersey (see website for picture) . . . . . . . . . . . . . . . . . . . .$50 . . . . . . . . . . . . . . . . _______ . . . . . . . . = . . . . . . .______
(while supplies last) size options: S-XXL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Size: _______
Donation to Habitat for Humanity of Wicomico County: . . . . . . . . . . . . . . . . . . . = . . . . . _______
Tax-deductible Donation to Salisbury University Scholarships and Grants: . . . . . . . . . . . . . . . . . . . = . . . . . _______
I support the League of American Bicyclists: ($1): . . . . . . . . . . . . . . . . . . . = . . . . . _______
Grand Total: . . . . . . . . . . . = . . ______
*This charge will appear as Salisbury University Foundation, Inc./SU Foundation, Inc. on your statement.
SU is an Equal Opportunity/AA/Title IX university and provides reasonable accommodation given sufficient notice to the University office or
staff sponsoring the event or program. For more information regarding SU’s policies and procedures, please visit www.salisbury.edu/equity.
RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY
AGREEMENT (“AGREEMENT”): In consideration for being permitted to
participate in any way in the Sea Gull Century/Metric Century
(“ACTIVITY”), an event sponsored by Salisbury University, I, for myself, my
personal representatives, assigns, heirs and next of kin:
1. ACKNOWLEDGE, agree and represent that I understand the nature of
bicycling activities and that I am qualified to participate in such Activity. I
further acknowledge that the Activity will be conducted over public roads
and facilities open to the public during the Activity and upon which the
hazards of traveling are to be expected. I further agree and warrant that if
at any time I believe conditions to be unsafe, I will immediately discontinue
further participation in the Activity.
2. UNDERSTAND that all participants in the Activity are required to
wear BICYCLING HELMETS, and I agree to wear a bicycle helmet while
riding a bicycle as part of any event connected with the Activity.
3. FULLY UNDERSTAND that (a) BICYCLING ACTIVITIES INVOLVE RISKS
and DANGERS OF SERIOUS BODILY INJURY, INCLUDING PERMANENT
DISABILITY, PARALYSIS AND DEATH (“RISKS”); (b) these Risks and dangers
may be caused by my own actions, or inactions, the actions or inactions of
other participants in the Activity, the condition in which the Activity takes
place, or THE NEGLIGENCE OF THE “RELEASEE” NAMED BELOW; (c) there
may be OTHER RISKS AND SOCIAL AND ECONOMIC LOSSES either not
known to me or not readily foreseeable at this time; and I FULLY ACCEPT
AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES,
COSTS AND DAMAGES I incur as a result of my participation in the Activity.
4. HEREBY RELEASE, DISCHARGE, COVENANT NOT TO SUE AND AGREE TO
INDEMNIFY AND SAVE AND HOLD HARMLESS Salisbury University, its
administrators, officers, volunteers, staff, agents and employees; other
participants; and any other sponsors (including Trek Bicycle Corporation, Park
Tools, Sun Rims and the League of American Bicyclists), advertisers and, if
applicable, owners and leasers of premises on which the Activity takes place
(the “RELEASEES” referred to herein) FROM ALL LIABILITY, CLAIMS, LOSSES
OR DAMAGES ON MY ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN
WHOLE OR IN PART BY THE NEGLIGENCE OF THE “RELEASEES” OR
OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS.
Emergency Contact
5. I GIVE Salisbury University UNRESTRICTED PERMISSION to use
and/or publish pictures of me for promotional purposes. I hereby waive any
right that I may have to inspect and approve the finished product or copy
that may be used in connection with an image that the photographer has
taken of me or the use to which it may be applied. I further release
Salisbury University from any claims for remuneration associated with any
form of damage, foreseen or unforeseen, associated with the proper
commercial or artistic use of images.
6. I understand that my registration information will not be shared or
released to other businesses for solicitation purposes.
7. There is no rain date; we ride rain or shine. In case of severe
weather, Sea Gull Century reserves the right to cancel/alter/modify the
tour for safety concerns. In any case, we do not refund tour entry fees or
transfer registrations to another tour year. In the unlikely case a tour is
canceled, you may claim your registration fee as a tax-deductible donation.
All funds raided through the Sea Gull Century tour supports Salisbury
University and the local community.
I have read this agreement, fully understand its terms, understand
that I have given up substantial rights by signing it and have signed it freely
and without any inducement or assurance of any nature and intend it to be
complete and unconditional release of all liability to the greatest extent
allowed by law and agree that if any portion of this agreement is held to be
invalid that the balance, notwithstanding, shall continue in full force and effect.
Important Information:
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Online registration open until noon 9/22
No Saturday Registration
No over-night parking available at SU
Make check payable and mail with
Registration Form to:
SU Foundation, Inc. - Sea Gull Century
P.O. Box 2655, Salisbury, MD 21802-2655
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SU is a smoke-free campus
EMERGENCY CONTACT
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EMERGENCY TELEPHONE
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PARTICIPANT’S SIGNATURE
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SIGNATURE OF PARENT/GUARDIAN (IF UNDER AGE 18)
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www.seagullcentury.org