| Bike
4 Sight Registration Print this form and mail your registration form and fee to: CBVI 100 West 15th Street Chester, PA 19013 |
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| Name: ____________________________________________ |
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| Address:___________________________________________ | ||||||
| City:___________________State:_____Zip Code:__________ | ||||||
| Email Address ______________________________ | ||||||
| Phone #:__________________Work #: __________________ | ||||||
| Cell #:____________________ | ||||||
| T-Shirt Size: S M L XL XXL | ||||||
| This will be my: ___________________Year Riding in B4S | ||||||
| Route Option: | ____ 62 Mile ____ 50 Mile | ____ 25 Mile | ||||
| ____ 13 Mile | ____ 2 Mile Family Ride | |||||
| ____ 2 Mile Walk-a-Long | ||||||
| $70 required
minimum donation is due day of ride! (Minimum Donation Included in Family Ride Registration Fee) |
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| Personal Fundraising Goal: ________________________ | ||||||
| Team Name: _____________________________________________ | ||||||
| I am the Team Captain: ___Yes ___No | ||||||
Registration
fee: |
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| Family Ride # of Riders___________________ | ||||||
Make checks payable to CBVI |
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| Credit Card Type: ______________ Credit Card Number: ____________________ | ||||||
| Expiration Date: ___________ Name on the Card: __________________________ | ||||||
Card Billing Address: __________________________ Zip Code: ______________ |
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