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Cyclist Information:

Full Name:

Status (check all that apply)

Phone Number
Email Address

Cycling Information:

How Often Do you Ride

What type of bike do you usually ride? (check all that apply)

What is your level of riding?

What is your longest ride to date? Miles

Have you ever taken a safety class?

List any volunteer activities:

     
   

 

Page maintained by Department of Sports & Fitness

Last updated or reviewed on 10/22/10

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