Cycle to the Summit Youth Scholarship
FOR EL PASO COUNTY RESIDENTS UNDER 18 ONLY
As a non-profit(c)3 organization, we need to collect certain data for grants and donations. Once you fill out the form below and the PDF on the next page, we will send you a code for a registration discount.
Name
*
First Name
Last Name
Age
*
Gender
*
Race
*
Ethnicity
*
Have you been impacted by COVID-19?
*
Yes
No
Have You Previously Competed in Cycle to the Summit
*
Yes
No
What school do you attend?
*
What grade level of school are you in?
*
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Parent or Guardian Information
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Is this a single parent household?
Yes
No
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Submit
Should be Empty: