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Read Liability Waiver
Price: $25.00
Are you renewing an existing membership
No
Yes (just fill in changes below)
First Name
Middle Name or Initial
Last Name
Address Line 1
Address Line 2
City
State
Zip
Country
Birth Date --Month
--Day
--Year
Day Phone xxx-xxx-xxxx
Is it OK to list your day phone number on the website?
Yes
No
Evening Phone
Is it OK to list your evening phone number on the website?
Yes
No
Cell Phone
Is it OK to list your cell phone number on the website?
Yes
No
Email
Is it OK to list your email address on the website?
Yes
No
Profession
Gender
Male
Female
What do you estimate you average road bike riding speed is, in MPH?
A - 20+
B - 16-19
C - 13-15
D - 10-12
E - Easy going
Shirt Size
I am willing to volunteer for the following (Thanks)
ride leader
major rides
registration
rest stops
SAG driver
first aid
board member
financial
newsletter
Agree to Liability Waiver
Agree
I agree to liability waiver
 
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