Bike 4 Sight Registration
Print this form and mail your registration form and fee to:
CBVI
100 West 15th Street
Chester, PA 19013

Full Name __________________________________________
Street Address ______________________________________
State ____City___________________________Zip Code:____________
Date of Birth ________________________________________
Phone Number (h) ____________________________________
(w) ________________________________ (c) ____________
Email ______________________________________________
This will be my ___________year riding in Bike4Sight.
Route Option:* ❏ Metric Century Ride ❏ 50 mile ride ❏ 25 mile ride  
  ❏ 13 mile ride ❏ 2 Mile Family Ride
All donations due day of ride!
Your Personal Fundraising Goal __________________________
Team Name _________________________________________
_____Yes, I am the Team Captain

Registration fee $35
Family Ride $25 x # of riders = __________________________
Walk A Long $25 _____________________________________

Make checks payable to CBVI
OR Pay by Credit Card

Credit Card Type: ❏ MC ❏ Visa ❏ Disc ❏ AMEX
Card # _____________________________________________
Expires _____________________________________________
Amount $ ___________________________________________
Signature ___________________________________________

 

Please mail your registration form and fee to:
CBVI at 100 W. 15th Street • Chester, PA 19013
*All Metric and 50 mile riders must enter Winterthur no later than 9:40 a.m.
No bicycles are permitted on the Winterthur grounds at any time except for
the Bike 4 Sight event