SIGN UP for Harrisonburg Bike to Work Day 2014! Signing up makes you and your workplace eligible for PRIZES! (Signing up also helps us keep track of how we're doing, so: THANK YOU!)
Name (or nickname if you prefer)
*
E-mail address (So we can contact you if you win a prize. We promise not to sell your email to spammers.)
*
Phone number (if you consider this a good way for us to reach you).
Workplace (We keep track of each workplace so we can award prizes and provide support.)
Approximate Commute Distance (round trip)
I am interested in being the contact person for my workplace
Yes
No
Maybe
I ride my bike to work
never
rarely
regularly
Do you want help planning your ride?
Yes! Which route has least hills? What do I wear? How do I pack my stuff?
No thanks, I've got it all sorted.
How did you hear about Hburg Bike2Work Day?
I am interested in joining Hburg Bike to Work Day's glamorous backstage organization. [PLEASE NOTE: there are no wrong answers. We won't judge.]
Sure, but just my favorite bits. Such as baking. Or handing out prizes.
No, that's alright. Y'all keep doing what you're doing.
Maybe. I can't find my calendar right now. We think the dog ate it.
Yes! This is my dream job! (Except my dream job would have a salary.)
Yes! Harrisonburg is a small city, so we have to make our own fun.
Questions or Comments
Submit Form
Should be Empty: