Language
English (US)
Riders and Support Crew Registration Form
Please scroll down for Additional Support Crew to be added if applicable.
$111 per Rider
$20 per Support Crew Member
Rider or Support Crew 1
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you need assistance transporting your bike or camp gear?
*
No
Yes both
Yes bike
Yes camp gear
Are you happy to assist in transporting others, bikes or camp gear? (If you have a trailer this would be highly beneficial to help others)
*
No
Yes, Others
Yes, Bikes
Yes, Camp Gear
Will you need a lift to Moora?
*
Yes
No
Unsure just yet
Are you registering additional Riders or Support Crew? (If yes, fill in their information below. If no, continue to the bottom and submit.
*
Yes
No
Rider 2
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you need assistance transporting your bike or camp gear?
No
Yes both
Yes bike
Yes camp gear
Are you happy to assist in transporting others, bikes or camp gear? (If you have a trailer this would be highly beneficial to help others)
No
Yes, Others
Yes, Bikes
Yes, Camp Gear
Will you need a lift to Moora?
Yes
No
Unsure just yet
Rider 3
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you need assistance transporting your bike or camp gear?
No
Yes both
Yes bike
Yes camp gear
Are you happy to assist in transporting others, bikes or camp gear? (If you have a trailer this would be highly beneficial to help others)
No
Yes, Others
Yes, Bikes
Yes, Camp Gear
Will you need a lift to Moora?
Yes
No
Unsure just yet
Rider 4
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you need assistance transporting your bike or camp gear?
No
Yes both
Yes bike
Yes camp gear
Are you happy to assist in transporting others, bikes or camp gear? (If you have a trailer this would be highly beneficial to help others)
No
Yes, Others
Yes, Bikes
Yes, Camp Gear
Will you need a lift to Moora?
Yes
No
Unsure just yet
Additional Support Crew
Room to add additional notes at bottom of form
Support Crew 2
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you need assistance transporting your bike or camp gear?
No
Yes both
Yes bike
Yes camp gear
Are you happy to assist in transporting others, bikes or camp gear? (If you have a trailer this would be highly beneficial to help others)
No
Yes, Others
Yes, Bikes
Yes, Camp Gear
Support Crew 3
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you need assistance transporting your bike or camp gear?
No
Yes both
Yes bike
Yes camp gear
Are you happy to assist in transporting others, bikes or camp gear? (If you have a trailer this would be highly beneficial to help others)
No
Yes, Others
Yes, Bikes
Yes, Camp Gear
Support Crew 4
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you need assistance transporting your bike or camp gear?
No
Yes both
Yes bike
Yes camp gear
Are you happy to assist in transporting others, bikes or camp gear? (If you have a trailer this would be highly beneficial to help others)
No
Yes, Others
Yes, Bikes
Yes, Camp Gear
Total amount of riders and support crew.
*
Please Select
X1 Rider $111
X2 Rider $222
X3 Rider $333
X4 Rider $444
X1 Support Member $20
X2 Support Member $40
X3 Support Member $60
X4 Support Member $80
X1 Rider x1 Support Member $131
X1 Rider x2 Support Member $151
X1 Rider x3 Support Member $171
X1 Rider x4 Support Member $191
X2 Rider x1 Support Member $242
X2 Rider x2 Support Member $262
X2 Rider x3 Support Member $282
X2 Rider x4 Support Member $302
X3 Rider x1 Support Member $353
X3 Rider x2 Support Member $373
X3 Rider x3 Support Member $393
X3 Rider x4 Support Member $413
X4 Rider x1 Support Member $464
X4 Rider x2 Support Member $484
X4 Rider x3 Support Member $504
X4 Rider x4 Support Member $524
Additional Comments
Do you accept the terms and conditions? Terms and conditions accessible on Cycle for Chanelle website
*
Yes
Submit
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