Online Registration

One registration for each team. Teams must register all at once. All fields required.

Event:

Team size:

Solo/Teammate #1 - (This should be the person providing payment)

Name:
Gender:	Female Male
Birthdate:
Street Address:
City:	State: Zip Code:
Country:
Email:	Phone:
Affiliation:	This is your personal club, team or school
T-shirt size
	I, Teammate #1, have read and agree with the Race Liability Waiver

Teammate #2

Name:
Gender:	Female Male
Birthdate:
Street Address:
City:	State: ZIP:
Country:
Email:	Phone:
Affiliation:	This is your personal club, team or school
T-shirt size
	I, Teammate #2, have read and agree with the Race Liability Waiver

Teammate #3

Name:
Gender:	Female Male
Birthdate:
Street Address:
City:	State: ZIP:
Country:
Email:	Phone:
Affiliation:	This is your personal club, team or school
T-shirt size
	I, Teammate #3, have read and agree with the Race Liability Waiver

Teammate #4

Name:
Gender:	Female Male
Birthdate:
Street Address:
City:	State: ZIP:
Country:
Email:	Phone:
Affiliation:	This is your personal club, team or school
T-shirt size
	I, Teammate #4, have read and agree with the Race Liability Waiver

This is a family entry

I do not need to submit payment - explain in Comment section below

Entry fee:

.

$ in USD
FEE $70 per rider, $140 per family

Comments:

Send me information

Pay by VISA, MasterCard, American Express, or Discovery credit card on the next page.