Website of the Maine Hospice Council and Center for End-of-Life Care

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Maine Hospice Event

Team Registration

To register, complete this form and click 'Submit.'  All registered teams will be listed on the "Online Pledge Form" and be eligible to receive pledges online.

Registration:  Team Captain. Please fill in the form below and click 'Submit' to complete registration. Your team name will be added to the list of teams on the Individual Registration Form. The $100 registration fee is due at time of registration and may be paid using PayPal (use any credit card or online check), by calling and giving a Visa/Mastercard, or by mailing your check.  Please allow 3 days (10 days if mailing a check) after registering your team before having each of your team members complete an individual registration.

You will be notified by email when individual team members register and when on-line pledges are made.

On event day, teams may check-in individually, or send just the team captain with all pledges.

This form also serves as your individual registration (choose a shirt size).

Team Captain

Registration Type

Team  ($100 registration fee)

Team Name

Event

50 mile trek (depart at 8:30)  75 mile trek (depart at 8:30) 25 mile trek (depart at 10:30)
Teams must check-in and depart at the same time. Please do not include 25 mile riders on a 50 or 75 mile team (or visa versa)

How many to you expect on your team?

Address

City, State, Zip

   

Daytime Phone

Email

Registration confirmations are sent by email. Please provide an email address to receive confirmation.

Emergency Contact
THIS IS REQUIRED

Event shirt

Adult Medium Adult Large   Adult Extra Large

Registration Fee:
$100 Individual

Registration fee is due at time of registration and may be paid by check or credit card.  Please select your payment method:
     I'll pay using PayPal
     I'll call 1-800-438-5963 and pay using my Visa/Mastercard
     I'll mail my check made payable to "Maine Hospice Council" to PO Box 2239, Augusta, ME 04338-2239

Pledge Goal

$   $100 Minimum per participant (teams may average their total pledges to achieve $100 per team member)

PLEASE do not send pledges with your registration. Keep collecting until ride day!

Agreements

 I agree to wear a helmet.
I agree to sign a "Liability Release Form"