6 Rider/Bike Team
*ALL FIELDS ARE REQUIRED*
Class
*
Please Select
Elite - Unlimited rider ability class and there are no restrictions on rider ability or age, intended for A, AA, and Pro riders
Expert- Limited to a maximum of one 'AA' Class rider on this team, all other riders must be ‘A’ or lower
Sportsmen- Limited to a maximum of one 'A' Class rider on this team, all other riders must be ‘B’ or lower
30+ - Riders must be over the age of 30
45+ - Riders must be over the age of 45
60+ - Riders must be over the age of 60
Novice- Limited to only 'C' Class racers. No 'A' or ‘B’ riders are allowed
Novice 40+ - Limited to only ‘C’ Class racers over the age of 40
Women- Riders must be female
Team Name
*
Please use good judgment in choosing a team name. Vulgar or inappropriate team names will not be allowed
Team Captain
*
Captain Phone Number
*
Please enter a valid phone number.
Team Captain Email
*
example@example.com
Team Number
Leave Blank - For GB Use
Rider 1 Name
*
First Name
Last Name
Rider 1 | Classification
*
Please Select
Pro
AA
A
B
C
This needs to be the Highest rider classification that you are/have competed in during 2023 and 2024 race season.
Rider 1 | Email
*
example@example.com
Rider 1 | Phone Number
*
Please enter a valid phone number.
Rider 1 | Street Address
*
Street, City, Zip code
Rider 1 | City
*
Rider 1 | State
*
Rider 1 | Zip Code
*
Rider 1 | Date of Birth
*
xx-xx-xxxx
Rider 1 | Emergency Contact Name
*
Rider 1 | Emergency Contact Phone
*
Please enter a valid phone number.
Rider 1 | Bike Year
*
Rider 1 | Bike Make
*
Rider 1 | Bike Model
*
Rider 1 | Bike CC Size
*
Rider 2 Name
*
First Name
Last Name
Rider 2 | Classification
*
Please Select
Pro
AA
A
B
C
This needs to be the Highest rider classification that you are/have competed in during 2023 and 2024 race season.
Rider 2 | Email
*
example@example.com
Rider 2 | Phone Number
*
Please enter a valid phone number.
Rider 2 | Street Address
*
Street, City, Zip code
Rider 2 | City
*
Rider 2 | State
*
Rider 2 | Zip Code
*
Rider 2 | Date of Birth
*
xx-xx-xxxx
Rider 2 | Emergency Contact Name
*
Rider 2 | Emergency Contact Phone
*
Please enter a valid phone number.
Rider 2 | Bike Year
*
Rider 2 | Bike Make
*
Rider 2 | Bike Model
*
Rider 2 | Bike CC Size
*
Rider 3 Name
*
First Name
Last Name
Rider 3 | Classification
*
Please Select
Pro
AA
A
B
C
This needs to be the Highest rider classification that you are/have competed in during 2023 and 2024 race season.
Rider 3 | Email
*
example@example.com
Rider 3 | Phone Number
*
Please enter a valid phone number.
Rider 3 | Street Address
*
Street, City, Zip code
Rider 3 | City
*
Rider 3 | State
*
Rider 3 | Zip Code
*
Rider 3 | Date of Birth
*
xx-xx-xxxx
Rider 3 | Emergency Contact Name
*
Rider 3 | Emergency Contact Phone
*
Please enter a valid phone number.
Rider 3 | Bike Year
*
Rider 3 | Bike Make
*
Rider 3 | Bike Model
*
Rider 3 | Bike CC Size
*
Rider 4 Name
First Name
Last Name
Rider 4 | Classification
*
Please Select
Pro
AA
A
B
C
This needs to be the Highest rider classification that you are/have competed in during 2023 and 2024 race season.
Rider 4 | Email
*
example@example.com
Rider 4 | Phone Number
*
Please enter a valid phone number.
Rider 4 | Street Address
*
Street, City, Zip code
Rider 4 | City
*
Rider 4 | State
*
Rider 4 | Zip Code
*
Rider 4 | Date of Birth
*
xx-xx-xxxx
Rider 4 | Emergency Contact Name
*
Rider 4 | Emergency Contact Phone
*
Please enter a valid phone number.
Rider 4 | Bike Year
*
Rider 4 | Bike Make
*
Rider 4 | Bike Model
*
Rider 4 | Bike CC Size
*
Rider 5 Name
First Name
Last Name
Rider 5 | Classification
*
Please Select
Pro
AA
A
B
C
This needs to be the Highest rider classification that you are/have competed in during 2023 and 2024 race season.
Rider 5 | Email
*
example@example.com
Rider 5 | Phone Number
*
Please enter a valid phone number.
Rider 5 | Street Address
*
Street, City, Zip code
Rider 5 | City
*
Rider 5 | State
*
Rider 5 | Zip Code
*
Rider 5 | Date of Birth
*
xx-xx-xxxx
Rider 5 | Emergency Contact Name
*
Rider 5 | Emergency Contact Phone
*
Please enter a valid phone number.
Rider 5 | Bike Year
*
Rider 5 | Bike Make
*
Rider 5 | Bike Model
*
Rider 5 | Bike CC Size
*
Rider 6 Name
First Name
Last Name
Rider 6 | Classification
*
Please Select
Pro
AA
A
B
C
This needs to be the Highest rider classification that you are/have competed in during 2023 and 2024 race season.
Rider 6 | Email
*
example@example.com
Rider 6 | Phone Number
*
Please enter a valid phone number.
Rider 6 | Street Address
*
Street, City, Zip code
Rider 6 | City
*
Rider 6 | State
*
Rider 6 | Zip Code
*
Rider 6 | Date of Birth
*
xx-xx-xxxx
Rider 6 | Emergency Contact Name
*
Rider 6 | Emergency Contact Phone
*
Please enter a valid phone number.
Rider 6 | Bike Year
*
Rider 6 | Bike Make
*
Rider 6 | Bike Model
*
Rider 6 | Bike CC Size
*
By checking the box below I attest the following is true:
*
By checking the box below I attest the following is true:
*
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6 Rider Team Registration
Team Registration Fee
$
450.00
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
submit
the form.
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