Mountain Bike Club Sign-up Form

East County Shred Mountain Bike Sign-up Form
Student Athlete Information
Athletes Name*

First NameLast Name
Grade
School
Age
Student Athlete Email
Cell Phone Number
Please enter a valid phone number.
Home Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/ Guardian Contact Information
Parent/Guardian 1

First NameLast Name
Cell Phone Number*
Work Phone Number
Address same as Student Athletes?
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Relationship to Athlete
Parent/Guardian 2

First NameLast Name
Address same as above?
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number
Please enter a valid phone number.
Work Phone Number
Please enter a valid phone number.
E-mail
example@example.com
Relationship to Athlete
Student Athlete Health Information
Does you have any health issues?*

YesNo
If yes, please explain
Survey
Check One:

I definitely will be an active member all seasonI am not sure if I can commit to the entire seasonI want to be on the team but have some conflicts
If you have conflicts, what are they and when
Experience:

Never riddenI ride a lot and have done some racingI ride now and then around townI train seriously and race a lotI've done some trail riding and/or distance road riding
Describe some of your goals for the season. For example, ride for fun and connect with others, to build strength and endurance or to compete and race at a serious level.
Do you need a bike and/or equipment?
We have lots of Volunteer opportunities, would you or anyone in your family be interested in helping our team by Volunteering?

YesNo
I give permission for my child's picture/video to be taken/used on Social Media

YesNo
Joining East County Shred requires 3 registrations and fees.

NICA Membership $50.00. You will pay this in The Pitzone (once this Sign Up Form is submitted you will get an email from eastcountyshred@gmail.com with direction on how to access your Pitzone and pay.Norcal League Registration $60.00. This will also be paid in the Pitzone.East County Shred Dues $175.00. Please use our East County Shred Venmo below to make you dues payment.
Joining East County Shred requires 3 registrations and fees.
East County Shred Dues $175.00. Payable through Venmo or Check
Norcal League Registration $60.00. This will also be paid in the Pitzone.
NICA Membership $50.00. You will pay this in The Pitzone (once this Sign Up Form is submitted you will get an email from eastcountyshred@gmail.com with direction on how to access your Pitzone and pay.
Should be Empty:

East County Shred Mountain Bike Sign-up Form

Joining East County Shred requires 3 registrations and fees.