2001 National Unicycle Convention Registration Form
July 16th to 21st, 2001 - Humber College, Toronto, Canada
Please use a separate form for each person
The USA Official Competition Rule Book will be used - All riders must be a member of the Unicycle Society of America
First Name:____________________ Last Name____________________ Date of Birth (mm/dd/yy)_______________
Address:_________________________________________________ Sex (circle one): M   F
City:____________________ State/Prov:__________________ ZIP/Postal Code:__________
Country:____________________ Phone:(___)__________ E-mail:____________________
Club Name:____________________ USA #:______________
If participant is under 18, name of parent/guardian/chaperone present at NUC 2001:________________________________________
Registration (Registration fee includes entrance to all official NUC events, public show and use of all facilities)
Competitor Registration Fee (before March 1, 2001) US $50.00 US$______
Late Competitor Registration Fee (March 1 to June 1, 2001) US $65.00 US$______
Very Late Competitor Registration Fee (after June 1, 2001) US $75.00 US$______
Non-Competitor Registration Fee US $35.00 US$______

Extra Show Tickets (Tickets for the Wed night public show will be available at the door for C$10)
 
US $ 5.00 x _____ = US$______
NUC 2001 T-Shirts US $ 16.00 x _____ = US$______
____Youth Small ____Youth Med ____Adult Small ____Adult Med ____Adult Large ____Adult X-Large ____Adult XXL
 
Bus Transportation (from Humber College and back to Humber College)
To downtown  Wed. July 18th US $ 5.00.. US$______
To York University Track & Field Centre  Thu. July 19th  Fri. July 20th US $ 5.00 x _____ = US$______
To Kelso Conservation Area for MUni  Sat. July 21st US $ 8.00.. US$______
Dormitory Accommodation at Humber College. All accommodations are single rooms with air conditioning and phone and include full breakfast
 Sun 15th  Mon 16th  Tues 17th  Wed 18th  Thu 19th  Fri 20th  Sat 21st ____ nights x US $20.00 per night = US $________
Alternate accommodation including hotel and camping is also available

Meals at Humber College (Also available to participants who are not using Humber College accommodation)
Breakfast: (breakfast is included in cost for Humber College Dormitory Accommodation. If you've booked a dorm do not select breakfast)
 Mon 16th  Tue 17th  Wed 18th  Thu 19th  Fri 20th  Sat 21st  Sun 22nd ____days x US $ 6.00 = US$ ______
Dinner:
 Sun 15th  Mon 16th  Tue 17th  Wed 18th  BBQ Thu 19th  Fri 20st  Sat 21nd ____days x US $ 10.00 = US$ ______

Checks in US Funds payable to "National Unicycle Convention 2001"TOTAL US $ _______
(Canadian residents may pay in Canadian Funds at current exchange ratesTOTAL C$ _________)


Please print this form.
Send the completed and signed form with a check for the full payment to:
(55 stamp required from United States)
Peter Groves
713 Markham Street,
Toronto, ON M6G 2M2, Canada

In consideration of the Unicycling Society of America, Inc., the host club, Toronto Unicyclists, Humber College, York University, the Corporation of the City of Toronto, and all other sponsors, agents, and representatives organizing and conducting the National Unicycle Convention from July 16th to 21st, 2001, and allowing me to participate in said event, I hereby waive, release, and discharge forever all above said organizations and their sponsors, agents, and representatives from all claims, demands, rights and causes of action of whatsoever kind and nature arising directly from any known/unknown, foreseen or unforeseen, bodily and personal injury, damage to property, and consequences thereof resulting from my participation in said National Unicycle Convention. I assume all risks of injury or mishap resulting from my participation and covenant, not to sue the aforementioned parties for said injuries and/or damage. I also permit USA and host club to provide furnish, or engage emergency medical treatment to me or my said son or daughter. I also give permission for the use of my name and/or picture in any broadcast, telecast, or other account of this event.
Emergency Contact Person: ___________________________________ Phone: (_____) ________________
__________________________________ _____________ _______________________________________
Signature Date Signature of Parent or Guardian

Please use a separate form for each person For questions on registration, please call Peter Groves at 416-531-3915 or e-mail at groves@pobox.com