Rider Registration - Step 1 of 3

Registration is $795 (or $495 for half the tour) and is payable by PayPal or credit card.

You will be directed to the PayPal site to make your payment on completion of the Rider Registration forms.

You do not need a PayPal account to pay by credit card; PayPal accepts all major credit cards.

All riders are required to raise a minimum of US$ 2,000 in donations for riders participating in the entire Tour and a minimum of US$ 1,000 for riders participating in either half of the Tour.

Donations are due by November 30th, 2008. Thanks to the generosity of our sponsors, 100% of all donations will go directly to the charities.

Please fill out the form below:

First Name: *Required

Last Name: *Required


Age:

Sex: Male Female

Jersey Size:

Mailing Address 1:

Mailing Address 2:

City:

State / Province:

Postal Code:

Country:

Day Phone:

Evening Phone:

Email: *Required

Emergency Contact: *Required

Contact Phone:

Participation:
Entire Ride (Dec 8th to Jan 5th) $795
North Segment (Dec 8th to Dec 22nd) $495
South Segment (Dec 22nd to Jan 5th) $495

Bike Rental:
No Bike Rental Necessary
One Segment (2 week rental, US$ 100)
Both Segments (4 week rental, US$ 200)

Single Supplement:
I am OK with Sharing a Room (No Charge)
One Segment (US$ 300)
Both Segments (US$ 600)

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