LA Ride Donation & Registration Form

Please use the below form to make a donation to the LA Ride to benefit student scholarship and/or registration as a rider.

complete one registration form per rider.

First Name *

Last Name *

ASLA Membership #

CLARB Membership #

Company *

Street Address *

City *

State *

Zip Code *

Phone Number *

Email Address *

LA Ride Sponsorship Donation Dollar Amount

LA Ride: Rider Registration - September 13

Individual Rider ($35)

LA Ride T-Shirt Size

Current Total:

$0.00

Rider Cancellation Policy *

All cancellation requests must be received in writing by September 6, and will be charged a $10 processing fee. After September 6, no refunds will be granted.

*

By registering for this event I agree to hold harmless Landscape Architects and Planners Inc., Michigan Chapter of the American Society of Landscape Architects (MiASLA) and the American Society of Landscape Architects (ASLA) from all claims, lawsuits, demands, causes of action, liability, loss, damage or injury of any kind whether brought by an individual or other entity or imposed by a court of law arising out of, in any way whatsoever, any acts, omissions, negligence, or willful misconduct on the part of the entities listed above, their officers, board members, employees, agents, invitees or volunteers relative to the Landscape Architecture Ride. This indemnification applies to, and includes, without limitation, the payment of all penalties, fines, judgments, awards, decrees, attorney fees and related costs and expenses and any reimbursements to the entities listed above for all legal fees, expenses and costs incurred by it related to this bicycle ride. The individual who is agreeing indicates that he/she has the legal authority to do so and is 18 years or older. If you are under 18 years of age you must have a guardian register on your behalf to participate in this event. This agreement shall be governed by the State of Michigan.

*

By registering for this event, I give the Michigan Chapter of the American Society of Landscape Architects and Landscape Architects & Planners, Inc, permission to use my name, likeness, image, voice, and/or appearance as such may be embodied in any pictures, photos, video recordings, audiotapes, digital images, and the like, taken or made on behalf of LA Ride activities. I agree that the Michigan Chapter of the American Society of Landscape Architects and Landscape Architects & Planners, Inc have complete ownership of such pictures, etc., including the entire copyright, and may use them for any purpose consistent with the LA Ride mission. These uses include, but are not limited to illustrations, bulle¬tins, exhibitions, videotapes, reprints, reproductions, publications, advertisements, and any promotional or educational materials in any medium now known or later developed, including the Internet. I acknowledge that I will not receive any compensation, etc for the use of such pictures, etc., and hereby release the Michigan Chapter of the American Society of Landscape Architects and Landscape Architects & Planners, Inc. and their agents and assigns from any and all claims which arise out of or are in any way connected with such use. If you do not consent, contact the MiASLA office at 517-485-4116.