BRAK - Bikes For Kids Annual Campaign Ride Registration Form 

All proceeds will be used by the Algona Rotary to purchase bikes for underprivileged children in our community.

Saturday, June 8, 2024 @ 8 a.m. -- (Registration begins at 7:30 a.m. and will close at 8 a.m.) 

$25 per entry for pre-registration by May 20, 2024. 

- Entry includes a "2024 BRAK - Bike for Kids" performance t-shirt. **Any registration after May 20 will NOT receive a t-shirt!**

Riders under the age of 16 MUST be accompanied by an adult. 

Questions about BRAK- Bikes for Kids can be emailed to algonarotary@gmail.com

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Email *
Name (First & Last) *
Participant Address *
Participant Phone *
Participant Age *
Emergency Contact Name & Phone Number  *

In consideration for the opportunity to participate in this event, I release all groups and person, including the City of Algona, IA, City of Bancroft, IA, County of Kossuth, IA, the State of Iowa, the Algona Rotary Club and all members, contributors, volunteers, etc. from any and all liability for any injury or damages whatsoever arising from any participation in this event. I also authorize any medical treatment deemed advisable by any licensed physician to relieve any injuries or illness while a participant or observer, AND, will be personally responsible for any costs incurred for said treatment. I certify that I have read and understood this document and agree with its content.

 *
Required

Shirt Size (Adult) 

 *
Required

VENMO payment to @Algona-RotaryClub - mention BRAK - Bikes for Kids 2024

OR 

Send check to: Algona Rotary Club, PO BOX 207, Algona, IA 50511 (Made payable to Algona Rotary) Please note: BRAK in memo line. 

Only paid registrations by May 20 will receive a shirt. 

**If you are a sponsored rider, please write the company that you are riding for in the choice below**

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