Big Island Rider Registration

Registration Form

If you wish to register for the 2012 Big Island Ride, please complete and print the following form and mail to Four Seasons. If you are under 18, you will need to have a parent or responsible adult accompany you on the Big Island Ride.

Once you submit your registration form, please mail a $50 registration fee to Tim Kneeland. You can also pay through Paypal to timkneeland@mac.com.

2750 Artesia Blvd. Unit 351.

Redondo Beach, CA 90278

Call Tim at 1-818-445-4060
Email: timkneeland@mac.com

Big Island Registration Form

Welcome to the 2012 Big Island Ride. Please complete the registration form, make a copy for yourself and hit the submit button below.

Today's Date: *
First Name: *
Last Name: *
Address: *
City: *
State:
Zip: *
Contact Phone: *
Cell Phone: *
DOB: *
Age: *
Sex: *
Email: *
Cycling Experience:
Signature-type name: *

The Big Island Ride is ridden at you own pace.....

Phone: 818-445-4060