Bluegrass Bike Partner Sign-up Form

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Partner/Location Name *

Physical Address *

Please use an address that will help us show your location on a map.

City *

County *

Phone Number

Please provide a phone number (including area code) that bicyclists can use to contact your business. Example: (859) 555-1212

Web Address

Pleave provide a link to your website or Facebook page (Not Required, but very helpful)

Location Description *

Examples: Restaurant, Food Store, Bike Shop, Retail Shop, Convenience Store, Private Residential

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