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ALYN 2024 Wheels of Love
In memory of Yakir Hexter, z'l. November 11-14, 2024. www.alyn.org/ride
Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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Please enter a valid phone number.
Route
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Please Select
Road
Road Plus
Challenge
Touring
Enduro (Off-Road)
Trail (Off-road)
Volunteer
Do you wish to ride or volunteer?
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Ride
Volunteer
We are considering adding a hiking option if there is sufficient interest. Would you be interested in this option?
Cycling jersey (sport cut) size
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Extra Small
Small
Medium
Large
Extra Large
2XL
3XL
4XL
Emergency Contact
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First Name
Last Name
Emergency Contact Phone
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Bicycle
*
Please Select
I am bringing a fully built bike
My bike will need to be assembled
I will assemble my bike myself
I need to rent a bike
Would you like to join a team? (Team captains must approve team members.)
Please Select
Grumpy Roadsters
Beitzim
Team Levenfeld
Friends of Kevin
Long Island Chain Gang
Let us know if you want to form a new team
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Would you like a special picture of yourself on your page? (Recommended)
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Would you like a single room during the ride (3 nights)? There is an additional cost of $750. We will bill you separately.
Requested Roommate during ride (Rooms are doubles)
Would you like a hotel room Sunday night before the ride? There is an additional cost of $250 for a single and $125 for a double. We will bill you separately.
Fundraising Goals are: $5,000 Road routes, $4,000 Off-road routes, 50% reduction for first time riders. Would you like to aim for a higher goal? (Just write the amount below.)
ID Number (TZ for Israelis, Passport for others)
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Date of Birth
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Month
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Day
Year
Date
Prescriptions/Allergies (if none, please write none)
Medical Conditions (if none, please write none)
Anything you would like us to know?
Please verify that you are human
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