Cycle Sequatchie Registration Form
What Base Route do You Intend to Ride?
*
15-Mile Route
35-Mile Route
50-Mile Route
70-Mile Route
90-Mile Route
103-Mile Three Mountain Challenge
Name of Registrant
*
First Name
Last Name
Name of Club or Group (if applicable)
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
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Anguilla
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The Bahamas
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Burkina Faso
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Mayotte
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Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
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Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
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Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
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Samoa
San Marino
Sao Tome and Principe
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Senegal
Serbia
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Slovenia
Solomon Islands
Somalia
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South Africa
South Ossetia
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Sri Lanka
Sudan
Suriname
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eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
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Zimbabwe
Other
Country
Mobile Phone
*
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Area Code
Phone Number
E-mail
*
Birthday
*
-
Month
-
Day
Year
Date Picker Icon
T-Shirt Size
*
Men's Small
Men's Medium
Men's Large
Men's XL
Men's XXL
Women's Small
Women's Medium
Women's Large
Women's XL
Women's XXL
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
-
Area Code
Phone Number
How Did You Hear About Us?
Personal Referral
Social Media
Internet
Another Bike Ride
Local Bike Shop
Club/Team Newsletter
Other
Vegetarian?
Yes I'm a vegetarian.
Velo View Newsletter?
Please send me periodic updates about bike tour opportunities and other cycling events in the Chattanooga tri-state region.
Interested in the Chattanooga Bicycle Club?
Yes, please send me more info about the Club.
Weather Disclaimer
*
I understand that the event will take place rain or shine. If the weather becomes too severe as determined by the ride organizers, I acknowledge that the ride will be canceled for the safety of all riders, and that no refunds will be issued.
Terms & Conditions
*
I hereby acknowledge and agree to the Terms & Conditions for participation in the ride and understand that there are no refunds.
Check-Out:
*
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FRIDAY, Oct 1, Jasper Highlands Hill Climb & Party (participation in the climb plus food & beer)
$
15.00
FRIDAY, Oct 1, Hill Climb Party only (food & beer without doing the climb)
$
5.00
How Many Tickets?
1
2
3
4
5
6
7
8
9
10
SATURDAY, Oct 2, Cycle Sequatchie Ride (participation in the ride plus food & beer)
$
65.00
SATURDAY, Oct 2, Cycle Sequatchie Ride 15-MILE ROUTE ONLY (participation in the ride plus food & beer)
$
30.00
SUNDAY, Oct 3, Sequatchie Cove Farm Tour & Lunch
$
65.00
How Many Tickets?
1
2
3
4
5
6
7
8
9
10
Add a Cycle Sequatchie Jersey
$
65.00
What Jersey Size?
Men's Small
Men's Medium
Men's Large
Men's XL
Men's XXL
Men's XXXL
Women's Small
Women's Medium
Women's Large
Women's XL
Women's XXL
Enter coupon
Apply
Total
$
0.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
SUBMIT YOUR REGISTRATION
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