Trip Date ... *

Trip name *

Name *

Address *

Email Address *

Additional Tour Participants

Type of Bicycle Select One Touring Bicycle Road Bicycle *

Bicycle Size

Inseam Length *

Arm Length *

Type of bicycle you currently use *

Previous Bicycle Trips

Do you have any specific medical issues that could cause an unforseen issue during the program

I have read and understand the cancellation information. I understand that there are some risks involved in Outdoor Activities and I participate in above program knowing these risks.  I will follow safety guidelines given to me by program provider and rules and regulations of local area.  In programs that involve alcohol I understand it can impair my ability to perform and will STOP if I feel overwhelmed by the effects or will follow the guidance of my program leader if they suggest I take a break from the activity.

I Agree *

Name *

Date ... *

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