Cyclerie Registration

CYCLERIE WAITLIST FORM

JOIN OUR WAITLIST
Bike Adventure Camp, 6/5-6/8/23 Mon-Thurs 9AM to 12 Noon, $285Learn to Pedal Camp, 6/12-6/15/23 Mon-Thurs 9AM to 12 Noon, $285Bike Adventure Camp, 6/19-6/22/23 Mon-Thurs 9AM to 12 Noon, $285Learn to Pedal Camp, 6/26-6/29/23 Mon-Thurs 9AM to 12 Noon, $285Trail Riders Level 1Trail Riders Level 2
Drop-In Dates Requested
Skip if you’re doing the whole week
Athlete Information
Athlete's Name*

First NameLast Name
Birth Date*

MonthDayYear
Second Athlete's Name

First NameLast Name
Birth Date

MonthDayYear
Athlete's Name 2

First NameLast Name
Athlete's Name 3

First NameLast Name
Grade
MaleFemale
Parent/Guardian Information
Name*

First NameLast Name
Cell Number*
Format: (000) 000-0000.
E-mail*
Address*

Street Address

Street Address Line 2

City

Zip Code
Should be Empty: