Ride for Independence 2026

Ride for Independence 2026

Rider Registration & Participation Waiver Packet supporting the Veterans Path to Independence Program. Hosted by Serenity Path Network LLC. Event date: Saturday, September 19, 2026, at Down Home Harley-Davidson, 2215 Hanford Road, Burlington, NC 27215.
Participant Information
Full Name

First NameMiddle NameLast Name
Preferred Name
Date of Birth

MonthDayYear
Date
Email Address
example@example.com
Mobile Phone
Please enter a valid phone number.Format: (000) 000-0000.
Mailing Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Registration Type
Registration Type
Motorcycle and Passenger Information
Motorcycle Make
Motorcycle Model
Motorcycle Year
Will you have a passenger?
Passenger Name

First NameLast Name
Passenger Notes or Restrictions
Veteran Recognition
Veteran status
Recognition options

Other
Payment Authorization or Reference Notes
Rider/Passenger Agreement Acknowledgments
Rider/Passenger agreement acknowledgments
Liability waiver acknowledgments
Participation rules acknowledgment
Emergency and conduct acknowledgment
Initials for rider agreement
Initials for liability waiver
Medical Emergency Authorization
Emergency Contact Name

First NameLast Name
Emergency Contact Phone
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Medical Authorization

Other
Medical Conditions or Alerts

Other
Photo and Media Release Choices
Photo Release Consent
Media Release Consent
Final Acknowledgment and Signature
Final acknowledgment
Signature
Printed name

My Products

Rider Registration Fee

Basic Rider Registration

$20.00

Passenger Registration Fee

Basic Rider & Passenger Registration

$15.00

Total

Payment Methods

Debit or Credit Card

ACH Bank Transfer

Klarna

Should be Empty:

Ride for Independence 2026

Participant Information

Registration Type

Motorcycle and Passenger Information

Veteran Recognition

Rider/Passenger Agreement Acknowledgments

Medical Emergency Authorization

Photo and Media Release Choices

Final Acknowledgment and Signature

My Products