Ride for the Living 2026 - PAS Delegation Registration

First Name (as it appears in your passport)

Last Name (as it appears in your passport)

Preferred First Name (if different)

Email

Phone Number

Date of Birth

Click below if you are interested in learning more about the PAS Israel trip for teens and parents taking place immediately after the Ride: from June 28 - July 2.

We are interested

Please choose an option for the bike ride for YOU (there will be additional opportunities below to let us know about other participants):

Ride For The Living (60 miles/97 km)Shorter bike route (first 14 miles/22 km)5K Walk For The Living (3 mile walk from the Plaszow Concentration Camp to JCC Krakow)
Non-rider (alternative programming will be provided in Krakow)

Please select the description that best represents your cycling proficiency:

Beginner (I know how to ride a bike but tend to ride infrequently and/or only short distances)Intermediate (I am comfortable riding short-medium distances and tend to do so regularly or semi-regularly)Expert (I can confidently ride long distances and tend to do so frequently and/or competitively)

On average, how many miles/km do you ride per week?

0 to 30 miles (~50 km)31 - 60 miles (50 - 97 km)More than 61 miles (~97 km+)

Will you be bringing your own helmet?

YesNo

What size helmet are you? Not sure? Measure head circumference at your forehead.

S (20-22in/52-56cm)M (21-23in/54-58cm)L (23-25in/58-62cm)

Please choose your jersey size:

Small (chest measurement: 37in/96 cm)Medium (chest measurement: 39in/100 cm)Large (chest measurement: 40in/104 cm)XL (chest measurement: 42in/108 cm)2XL (chest measurement: 44in/112 cm)3XL (chest measurement: 45in/116 cm)4XL (chest measurement: 47in/120 cm)

Please choose your t-shirt size:

Small (chest measurement: 37in/96 cm)Medium (chest measurement: 39in/100 cm)Large (chest measurement: 42in/108 cm)XL (chest measurement: 44.5in/114 cm)2XL (chest measurement: 47in/120 cm)3XL (chest measurement: 49in/126 cm)

Your Height in Feet and Inches

Dietary Needs / Food Allergies

Please let us know about any relevant medical conditions or special needs that might impact your participation in the program in any way:

Family Address

Street Address

Street Address Line 2

City

State

Zip Code

Total Number of Adults (including you)

Total Number of Teens

Total Number of Rooms

Room 3

Hotel Room Options

Full 4-day program - STRADOM House Hotel - For one person - $3,684 Per PersonFull 4-day program - STRADOM House Hotel - Two people in the room - $3,208 Per PersonFull 4-day program - STRADOM House Hotel - Three people in the room (one in a roll-away bed) - $3,008 Per Person

Name of Second Person

Name of Third Person

Please specify bed configuration:

King Size BedTwo Twin Beds

First Name (as it appears in their passport)

Last Name (as it appears in their passport)

Preferred First Name (if different)

Phone Number

Date of Birth

Please choose an option for the bike ride:

Please select the description that best represents your cycling proficiency:

On average, how many miles/km do you ride per week?

0 to 30 miles (~50 km)31 - 60 miles (50 - 97 km)More than 61 miles (~97 km+)

Will you be bringing your own helmet?

YesNo

What size helmet are you? Not sure? Measure head circumference at your forehead.

S (20-22in/52-56cm)M (21-23in/54-58cm)L (23-25in/58-62cm)

Please choose your jersey size:

Please choose your t-shirt size:

Your Height in Feet and Inches

Dietary Needs / Food Allergies

Please let us know about any relevant medical conditions or special needs that might impact your participation in the program in any way:

Third Adult

Covid-19 and other force majeures waiver:

1. Participation includes possible exposure to and illness from infectious diseases including COVID-19 (and other force majeures). While particular event rules and personal discipline may reduce this risk, the risk of serious illness and death does exist;

2. I knowingly and freely assume all such risks related to illness and infectious diseases, such as COVID-19;

3. I hereby knowingly assume the risk of injury, harm and loss associated with participation in Ride For The Living, including any injury, harm, and loss caused by the negligence, fault or conduct of any kind on the part of JCC Krakow and/or Ride For The Living.

We agree to Ride For The Living's 2026 Covid-19 and other force majeures waiver listed above.

We agree to Ride For The Living 2026's terms, conditions, and cancellation policy. I hereby maintain that each member of my family is fit and healthy enough to participate in Ride For The Living 2026 in Krakow. I also accept that JCC Krakow, Ride For The Living, and any affiliated vendors, staff members, or volunteers cannot be held responsible for any personal injury, accident, loss, damage, or public liability during the event.

We agree.

First Name on Card

Last Name on Card

Credit Card Number

Exp Month

Exp Year

Security Code

Billing Address

Billing City

Billing State

Billing Zip Code

Bank Routing Number

Bank Account Number

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