Big Island Ride Rider Registration Form

Registration Form

Please complete, print, sign, include payment, and mail to:

Four Seasons Cycling Events
6311 148th Pl SW
Edmonds, WA 98026

Questions:
Call Tim at 1-818-445-4060
Email: timtka@aol.com
Website: http://www.BigIslandRide.com
http://www.FourSeasonsCyclingEvents.com

Today's Date:

Event:                      _____

Last Name:

First Name:

Name you wish to be called:

Address:

City:

State/Province:

Zip or Postal Code:

Home Phone:

Work Phone:

Cell Phone:

Where did you hear about the ride?

Birth date:                                                   Age:

Sex: M     F         Shirt Size: Sm   Med    Lg    XL

Email Address:

Webpage:

Cycling Experience:    Novice Some      Lots     Several years    Expert

Amount Enclosed:

Signature:

Parent's signature if under 18:

The Four Season's events are ridden at you own pace.....