Register for The 100 Ride 2025

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Registration Information

First Name: *

Last Name: *

Address: *

City: *

State: *

Zip / Postal: *

Country: *

Cell Number: *

Email Address: *

Date of Birth: *

Jersey Size: *

Emergency Contact Information

Emergency Contact: *

Emergency Phone: *

Fundraising Commitment

I understand that by participating in the The 100 Ride I am committing myself to raise a donation minimum of $1,800. If for any reason I am not able to meet the minimum requirement by race day I will be responsible for the difference which will be charged to my credit card on file.

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Account Information

Custom URL:* Create your custom url to use for your personal fundraising page (This will also be your account username)

https://www.the100ride.com/

Sign in with Google or choose a password. You will need it to view / edit your personal web page, and see who has sponsored you for this event.

Password: *

Re-Type Password: *

Additional Information

Have you previously ridden in a group event? *

Yes No

In addition to riding are you interested in a sponsorship opportunity? *

Yes No

Additional Comments:

Waiver and Release

I acknowledge that this athletic event is an extreme test of a person's physical and mental limits and carries with it the potential for death, serious injury and property loss. The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, rain, condition of athletes, equipment, vehicular traffic, actions of other people including, but not limited to, participants, volunteers, spectators, coaches, event officials, event organizers, and event monitors, and/or producers of the event, and lack of hydration. These risks are not only inherent to athletics, but are also present for volunteers. I hereby assume all of the risks of participating and/or volunteering in this event. I realize that liability may arise from negligence or carelessness on the part of the persons or entities being released. This liability may arise from lack of proper planning, road closures, dangerous or defective equipment or property owned, maintained or controlled by them or because of their possible liability without fault.

I certify that I am physically fit, have sufficiently trained for participation in the event and have not been advised otherwise by a qualified medical person.
I acknowledge that this Accident Waiver and Release of Liability (AWRL) form will be used by the event holders, sponsors, volunteers, beneficiaries and organizers of events in which I shall participate and that it will govern my actions and responsibilities at said events and thereafter.
I have been advised by the organizers of the ride not to ride in the rain or poor weather conditions. If I ride in those conditions it is at my own risk and I will not hold any person or entity responsible for any outcome damage or liability.

In consideration of my application and permitting me to participate in this event, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) Waive, Release and Discharge from any and all liability for my death, disability, personal injury, property damage, property theft or actions of any kind which may hereafter accrue to me or my traveling to and from this event, THE FOLLOWING ENTITIES OR PERSONS: 
The 100 Ride, Inc.
Kupath Ezra of Rockland County
Tomche Shabbos of Rockland County
Ari Senter
Uri Kirschner
Moshe Goldblatt
All participants, volunteers, spectators, coaches, event officials, event organizers, and event monitors, and/or producers of The 100 Ride biking event
Village of Wesley Hills
The people of the State of New York and the Palisades Interstate Park Commission 
All governmental municipalities and agencies, 
their directors, officers, employees, volunteers, representatives, and agents, the event holders, event sponsors, event directors, event volunteers, and co-participants; (B) Indemnify and Hold Harmless the entities or persons mentioned in this paragraph from any and all liabilities or claims made by any individuals or entitles as a result of the event or as a result of any of my actions or things which may have happened to me during this event.

I hereby consent to receive medical treatment which may be deemed advisable during the riding event or in the event of injury, accident and or illness during this event.
I understand that at this event or related activities, I may be photographed. I agree to allow my photo, video or film likeness to be used for any legitimate purpose by the event holders, producers, sponsors, organizers and or assigns.

This AWRL shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.

I hereby certify that I have read this document; and, I understand its content.

I accept the above waiver and release

Only enter this field if you were told to do so by a staff member.

The 100 Ride is a non-profit 501c3 organization.

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