2021 Cycle Sequatchie Century Registration Form

What Base Route do You Intend to Ride? *

15-Mile Route 35-Mile Route 50-Mile Route 70-Mile Route 85-Mile Route 102-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 Country

Mobile Phone *

Area Code Phone Number

E-mail *

Birthday *

Month Day Year

T-Shirt Size *

Emergency Contact Name *

First Name Last Name

Emergency Contact Phone Number *

Area Code Phone Number

How Did You Hear About Us?

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: *

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?

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?

Add a Cycle Sequatchie Jersey $ 65.00

What Jersey Size?

Enter coupon

Total $ 0.00

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Cycle Sequatchie Registration Form