Devil Mountain Double Century Ride Application - Saturday April 27, 2019
Entry Fee: $110.00 ($130.00 after March 31st)
Optional contribution to the
Tom Milton Memorial AED Fund
Check-in is at the San Ramon Marriott, 2600 Bishop Drive, San Ramon, CA, 94583,
Friday evening between 6 & 8 or Saturday morning between 4 & 6.
You will be required so 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.
Total Due.
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