6 Rider/Bike Team
*ALL FIELDS ARE REQUIRED*
Class
*
Please Select
Elite - Unlimited rider ability class and there are no restrictions on rider ability or age, intended for A, AA, and Pro riders
Expert- Limited to a maximum of one 'AA' Class rider on this team, all other riders must be ‘A’ or lower
Sportsmen- Limited to a maximum of one 'A' Class rider on this team, all other riders must be ‘B’ or lower
30+ - Riders must be over the age of 30
60+ - Riders must be over the age of 60
Novice- Limited to only 'C' Class racers. No 'A' or ‘B’ riders are allowed
Women- Riders must be female
Team Name
*
Please use good judgment in choosing a team name. Vulgar or inappropriate team names will not be allowed
Team Captain
*
Captain Phone Number
*
Please enter a valid phone number.
Team Captain Email
*
example@example.com
Team Number
Leave Blank - For GB Use
Rider 1 Name
*
First Name
Last Name
Rider 1 | Classification
*
Please Select
Pro
AA
A
B
C
This needs to be the Highest rider classification that you are/have competed in during 2023 and 2024 race season.
Rider 1 | Email
*
example@example.com
Rider 1 | Phone Number
*
Please enter a valid phone number.
Rider 1 | Street Address
*
Street, City, Zip code
Rider 1 | City
*
Rider 1 | State
*
Rider 1 | Zip Code
*
Rider 1 | Date of Birth
*
xx-xx-xxxx
Rider 1 | Emergency Contact Name
*
Rider 1 | Emergency Contact Phone
*
Please enter a valid phone number.
Rider 1 | Bike Year
*
Rider 1 | Bike Make
*
Rider 1 | Bike Model
*
Rider 1 | Bike CC Size
*
Rider 2 Name
*
First Name
Last Name
Rider 2 | Classification
*
Please Select
Pro
AA
A
B
C
This needs to be the Highest rider classification that you are/have competed in during 2023 and 2024 race season.
Rider 2 | Email
*
example@example.com
Rider 2 | Phone Number
*
Please enter a valid phone number.
Rider 2 | Street Address
*
Street, City, Zip code
Rider 2 | City
*
Rider 2 | State
*
Rider 2 | Zip Code
*
Rider 2 | Date of Birth
*
xx-xx-xxxx
Rider 2 | Emergency Contact Name
*
Rider 2 | Emergency Contact Phone
*
Please enter a valid phone number.
Rider 2 | Bike Year
*
Rider 2 | Bike Make
*
Rider 2 | Bike Model
*
Rider 2 | Bike CC Size
*
Rider 3 Name
*
First Name
Last Name
Rider 3 | Classification
*
Please Select
Pro
AA
A
B
C
This needs to be the Highest rider classification that you are/have competed in during 2023 and 2024 race season.
Rider 3 | Email
*
example@example.com
Rider 3 | Phone Number
*
Please enter a valid phone number.
Rider 3 | Street Address
*
Street, City, Zip code
Rider 3 | City
*
Rider 3 | State
*
Rider 3 | Zip Code
*
Rider 3 | Date of Birth
*
xx-xx-xxxx
Rider 3 | Emergency Contact Name
*
Rider 3 | Emergency Contact Phone
*
Please enter a valid phone number.
Rider 3 | Bike Year
*
Rider 3 | Bike Make
*
Rider 3 | Bike Model
*
Rider 3 | Bike CC Size
*
Rider 4 Name
First Name
Last Name
Rider 4 | Classification
*
Please Select
Pro
AA
A
B
C
This needs to be the Highest rider classification that you are/have competed in during 2023 and 2024 race season.
Rider 4 | Email
*
example@example.com
Rider 4 | Phone Number
*
Please enter a valid phone number.
Rider 4 | Street Address
*
Street, City, Zip code
Rider 4 | City
*
Rider 4 | State
*
Rider 4 | Zip Code
*
Rider 4 | Date of Birth
*
xx-xx-xxxx
Rider 4 | Emergency Contact Name
*
Rider 4 | Emergency Contact Phone
*
Please enter a valid phone number.
Rider 4 | Bike Year
*
Rider 4 | Bike Make
*
Rider 4 | Bike Model
*
Rider 4 | Bike CC Size
*
Rider 5 Name
First Name
Last Name
Rider 5 | Classification
*
Please Select
Pro
AA
A
B
C
This needs to be the Highest rider classification that you are/have competed in during 2023 and 2024 race season.
Rider 5 | Email
*
example@example.com
Rider 5 | Phone Number
*
Please enter a valid phone number.
Rider 5 | Street Address
*
Street, City, Zip code
Rider 5 | City
*
Rider 5 | State
*
Rider 5 | Zip Code
*
Rider 5 | Date of Birth
*
xx-xx-xxxx
Rider 5 | Emergency Contact Name
*
Rider 5 | Emergency Contact Phone
*
Please enter a valid phone number.
Rider 5 | Bike Year
*
Rider 5 | Bike Make
*
Rider 5 | Bike Model
*
Rider 5 | Bike CC Size
*
Rider 6 Name
First Name
Last Name
Rider 6 | Classification
*
Please Select
Pro
AA
A
B
C
This needs to be the Highest rider classification that you are/have competed in during 2023 and 2024 race season.
Rider 6 | Email
*
example@example.com
Rider 6 | Phone Number
*
Please enter a valid phone number.
Rider 6 | Street Address
*
Street, City, Zip code
Rider 6 | City
*
Rider 6 | State
*
Rider 6 | Zip Code
*
Rider 6 | Date of Birth
*
xx-xx-xxxx
Rider 6 | Emergency Contact Name
*
Rider 6 | Emergency Contact Phone
*
Please enter a valid phone number.
Rider 6 | Bike Year
*
Rider 6 | Bike Make
*
Rider 6 | Bike Model
*
Rider 6 | Bike CC Size
*
By checking the box below I attest the following is true:
*
By checking the box below I attest the following is true:
*
Signature
*
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6 Rider Team Registration
Team Registration Fee
$
550.00
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
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