Check the box
below to certify that
you are 18 or older
and have read and
agree to the
Waiver, Safety
Affirmation, and
Release.



New Member
Renewing Member
Family - $40/year
Individual - $20/year
First Name:
Last Name:
Email:
Home Phone:
Cell Phone:
City:
Zip
Street:
Apt. No.:
State:
How did you hear about 3RBC?
Renewing member
3RBC Online website
Ride or Event
Referred by:
Other:
Names of all other cyclists to be included in this membership (family memberships only).
Entries shown in RED are required.





Email addresses of all other cyclists to receive 3RBC messages (family memberships only).
Newsletter
Advertising
Board Member
Fundraising
Events (Bike-To-Work, century ride, etc.)
Bicycle Friendly Communities
Education
Community Advisory Council
Coalition Officer
The 3RBC needs your help!

Please check to show where you would be willing to offer assistance in any of the following activities.
Waiver, Safety Affirmation, and Release:

In consideration of the acceptance of this membership application and of being allowed to participate in 3 Rivers Bicycle Coalition activities, I hereby personally assume all risks in connection with those activities and I further agree to forever release, discharge, waive, save and hold harmless the 3 Rivers Bicycle Coalition, the Officers, Board of Directors, Sponsors and any Agents from any claim by me, or by my family, estate, heirs or assigns arising out of my participation in these activities. This includes, but is not limited to, waiving any and all fights, demands, or claims for damages and causes for suits or actions known or unknown, and further includes but is not limited to medical expenses or other expenses in the event of accidents, illness, other incapacity, death or damage to property. I further state that I am of lawful age and legally competent to sign this Affirmation, Waiver and Release. I understand that the terms of this document are contractual and not a mere recital and I have signed this document as my own free act. I attest and verify that I have full knowledge of the risks involved in participation of Coalition activities. I have fully informed myself of the contents of the Affirmation, Waiver and release by reading it before checking the box at left.
Payment will be processed by PayPal on a secure site. You may use a major credit or debit card. You do not need a PayPal account.
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Get  Fit - Have Fun - Cycle Tri-Cities
3 Rivers Bicycle Coalition
The mission of the 3RBC is to provide a bicycling advocacy and resource organization that promotes improved quality of life in and around the Tri-Cities area of Washington State.
Get  Fit - Have Fun - Cycle Tri-Cities
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If you do not want to
use this online form,
please download the
membership form at
this link.
3 Rivers Bicycle Coalition is a registered 501(c)3 organization.
Your membership is tax-deductible to the fullest extent allowable by law.
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