St. Henry Steeple Chase
Registration Form
Please complete both sides of the registration
form, detach and send with registration fee to:
Celebrating the St. Henry
Community Picnic
The Steeple Chase Bike Tour
In care of Joanne Niekamp
PO Box 360
St. Henry, OH 45883
Name
Address
City, State, Zip
Phone
St. Henry Catholic Cluster
July 6th, 2013
St. Henry, Ohio
15, 20 or 30 mile routes
Email
o I woud like notice of upcoming events.
Please indicate the course you intend to ride.
o The Mini (15 miles)
o The Mini-Plus (20 miles)
o The Full (30 miles)
Join us for a relaxing ride
through the historic land of the
cross-tipped churches, featuring
the St. Henry Catholic Cluster.
Registration Fee:
Postmarked by June 19th, 2013
o $20 with short sleeved T-shirt
o $10 without T-shirt
Postmarked after June 19th, 2013
o $12 without T-shirt
Circle T-shirt size:
S
M
L
Please make checks payable to:
St. Henry Community Picnic
XL
XXL
For more information, please visit:
www.sthenrybank.com
Click on Our Community. Under Upcoming Events,
click on The Steeple Chase Bike Tour.
Find us on Facebook:
Steeple Chase Bike Tour
Email: [email protected]
For more information, please visit:
www.sthenrybank.com
Click on Our Community. Under Upcoming Events,
click on The Steeple Chase Bike Tour.
Find us on Facebook:
Steeple Chase Bike Tour
Email: [email protected]
About the ride….
There are three options for the tour:
n Mini Steeple Chase
This 15 mile route starts in St. Henry and takes
you past 2 historic cross-tipped churches including
St. Wendelin and St. Bernard, before heading back
to St. Henry.
n Mini-Plus Steeple Chase
This 20 mile route also includes St. Frances
Church, adding an additional 5 miles to the Mini.
n Full Steeple Chase
This 30 mile route starts in St. Henry and takes
you past 3 historic cross-tipped churches including
St. Wendelin, St. Bernard and St. Francis. You
will also ride past and have the opportunity to visit
the newly-renovated St. Charles Seminary, before
returning back to St. Henry.
If time is not a factor for your day, we invite you
to stop and tour each of the beautiful landmark
churches and enjoy some refreshments along the
way. Restrooms will be available at each stop.
Registration Information…
Registration forms can be completed and mailed in
or same day registration is available.
Registration Fee:
Postmarked by June 19th, 2013
$20 with short sleeved T-shirt
$10 without T-shirt
Postmarked after June 19th, 2013
(or same day registration)
$12 without T-shirt
On the day of the ride….
Check In/Same Day Registration:
All riders are required to check in at the registration
booth prior to the start in order to receive the ride
packet, maps, and other pertinent information for
the tour.
Same day registration will start at 7:00 a.m.
Location:
The registration booth will be located at the
St. Henry High School Columbus St. parking lot.
391 E. Columbus St., St. Henry, OH 45883
Directions: On entering St. Henry from S.R. 118,
turn West on Columbus Street. The high school is
located on the right.
Starting time – 8:00 a.m.
The bike tour will be held rain or shine.
Vehicle support will be available until 12:00.
Other information….
n All
St. Henry Steeple Chase
Bike Tour Waiver Form
In consideration of the Saint Henry Steeple Chase
Bike Tour accepting this entry form, I, on behalf
of myself and all of those who may have a right to
seek recourse on my behalf, hereby waive, release
and forever discharge The Saint Henry Steeple
Chase Bike Tour Committee, its representatives,
agents, co-sponsors, participants, officials, and
all others connected with the event, from any and
all rights and claims that may accrue for any injuries
and/or damages incurred by me in connection
with my association with, during, or after the
event. I attest and verify that my bicycle is in safe
working-order, and that I am physically fit and
have completed sufficient training for this event.
traffic rules must be followed during the event.
n Roads
n All
Registration Form (cont.)
will not be closed to traffic.
Participant Signature
riders MUST wear helmets.
n Route
maps will be provided on the day of the
tour. In addition, all routes will be marked and
patrolled by support vehicles.
Date
n Rest
A parent or legal guardian signature is required if
the participant is a minor or under guardianship.
stops with refreshments will be provided
at the church parking lots.
o (I will) o (I will not) be 18 as of July 1,2013.
n Registration
will be necessary to receive
information packets and maps.
n Parent
or legal guardian signature required if
participant is a minor or under guardianship.
A limited quantity of T-shirts may be available for
purchase the day of the tour.
For more information, visit:
www.sthenrybank.com
Click on Our Community. Under Upcoming Events, click on The Steeple Chase Bike Tour.
Find us on Facebook:
Steeple Chase Bike Tour
Parent or Legal Guardian