2026 CYCLING Participant Registration Form

Name

First NameLast Name

Gender

Date of Birth

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Home Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Cell Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Are You a Military Vet?

If Yes, Which Branch?

Personal Information (please be as specific as possible):

Disability

Date of Disability Onset

Height / Weight

Cyclers must be 210lbs or less and must be able to fit into an 18" wide wheelchair.

Please choose your most frequent mode of mobility:

If 'Other', please specify:

Please list any assistive devices or braces used

Any previous cycling experience and equipment used (since disability):

List other sports you participate in on a regular basis.

Are you currently under a doctor's care for any condition? If yes, please explain.

Are you allergic to anything [i.e. food, sun, medication]? If yes, please explain.

Do you need to limit your activities for any reason? If yes, please explain.

Do you have seizures?

Within the past six months, have you had any injury to, or surgery on your back, spinal cord, or hips? If yes, please explain.

Do you wear a back brace or have Harrington Rods? If yes, please describe.

Are there any other special medical conditions TRAS should know about (asthma, diabetes, heart trouble, etc.)? If yes, please explain.

List medications you are currently taking:

Provide an Emergency Contact Name, Phone number, and Relationship to you.

Clicking the 'Submit' button will take you to the Liability Waiver Form

2026 Cycling Participant Registration Form