Please complete a separate form for each child. Revo Devo Registration Form Rider Registration Form Child's Name* First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Child's Phone #Child's Email Address Parent/Legal Guardian Name First Last Relationship to ChildParent/Legal Guardian PhoneParent/Legal Guardian email Parent/Legal Guardian Name First Last Relationship to ChildParent/Legal Guardian PhoneParent/Legal Guardian email What is your child's birthdate?* Date Format: DD slash MM slash YYYY How many years had your child been riding/racing bikes?Consent* I agree to the Revolution Development Cycling Junior Development Cycling Team Family Membership Agreement.In consideration of Revolution Development Cycling Junior Cycling Team, family membership, heretofore known as Revolution Development Cycling, I, the participating child (“Child”) and his/her parent (“Parent”,and together with the Child and other members of their family, the “Family”) hereby agree and acknowledge as follows: 1. The Child is proud to be associated with Revolution Development Cycling and will positively promote the organization and it’s products; 2. The Child will wear and use any and all Revolution Development Cycling products provided byRevolution Development Cycling during racing or training;3. The Family will conduct themselves in a positive and mature manner at all times, including showing respect for others while wearing or using the Revolution Development Cycling logo or products; failure to do so can lead to the Child’s release from the team as determined by the board. 4. The Child and Parent, on behalf of themselves, the Family, and their respective successors and heirs, hereby release, indemnify and hold Revolution Development Cycling harmless and all of its sponsors from any and all claims and causes of action, losses, liabilities or costs, of whatever nature involving, but not limited to, physical or mental injury to theChild, Parent, any member of their Family, or any third party, relating to or in any manner connected with my membership in the Family’s involvement with Revolution Development Cycling or my Family’s use of any products, clothing materials or equipment provided to me by Revolution Development Cycling or any of the Revolution Development Cycling sponsors; 5. The Child and Parent grant Revolution Development Cycling and its sponsors the irrevocable right to use the Child’s name and reprint any photograph of Child as it relates to theChild’s membership in Revolution Development Cycling; 6. The Family shall follow the IMBA, USA Cycling,USCF, NORBA and NCNCA rules and regulations and codes of conduct; 7. The Child agrees to do his/her part for the sport of cycling and Revolution DevelopmentCycling including, but not limited to, event volunteering, trail and hay bale maintenance, cone placement and pick up, and general post event cleanup as needed; 8. In the event Revolution Development Cycling terminates the Family membership, the Child shall immediately return any Revolution Development Cycling products and equipment provided but not paid for by the Family; 9. The term of this agreement shall be for the calendar year of submission and is not assignable or transferable; Dues expire and must be repaid 2/1 of each year. 10. The Family understand and agree that the members of Revolution Development Cycling shall beheld to a strict code of ethics and standards. Revolution Development Cycling may cancel the Family’s membership in the event of poor Revolution Development Cycling representation or poor conduct or violation of any of the above provisions. Revolution Development Cycling shall have the right to censure, suspend, and or revoke rider membership should any member of theFamily behave inappropriately or unprofessionally during an event. Event shall be defined as a Revolution Development Cycling sponsored race, special event, or training ride, USA Cycling sanctioned race or Non USA Cycling race; 11. The Child agrees to always wear a helmet in support of safety whenever the Child rides by bicycle. 12. The primary objective for all Revolution Development Cycling members is to: RIDE, LEARN,RACE & HAVE FUN!!! 13. By accepting this agreement the Child and Parent acknowledge that each has reviewed this agreement and will abide by the policies set forth in this agreement.