Knoxville Fall Classic Double Century Ride Application - Saturday September 29th, 2018
Entry Fee: $100.00 ($120.00 after August 31st)
Check-in is at Pena Adobe Park, 4699 Pena Adobe Rd, Vacaville, CA 95687
Friday evening between 6 & 8 or Saturday morning between 4:00 & 6:30.
You will be required to sign a waiver at check-in prior to riding.
Rider Information - Note: Fields marked with a red asterisk (
*
) are required.
First Name
*
Middle Name
Last Name
*
Gender
*
Male
Female
Birthdate
*
eMail
*
Address
*
City
*
State
*
Zip
*
Phone #
*
Alternate Phone #:
Emergency Contact Name
*
Emergency Phone
*
Tandem Partner:
Entry Fee. Please only change if you are utilizing a volunteer credit.
Tom Milton Memorial AED fund pledge amount.
CTC Awards Breakfast prepay (recommended $10/person).
Total Due.
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