Signup Form - St Croix Valley D-Team 4th - 5th graders (fall 2021)
Please fill out the form below with your rider information. After you complete this form you will be given a link to pay the team dues via Paypal (you can use a credit card, you do not need a paypal account) If you don't wish to pay online please contact us at
stcroixcycling@gmail.com
* Required
Rider First Name
*
Your answer
Rider Last Name
*
Your answer
Rider Email Address
*
Your answer
Rider Phone Number - Will get txts from time to time about Practice & Race information
Your answer
Parent 1 - Name (First Last)
*
Your answer
Parent 1 - Email Address
*
Your answer
Parent 1 Phone Number - Will get txts from time to time about Practice & Race information
*
Your answer
Parent 2 - Name (First Last)
Your answer
Parent 2 - Email Address
Your answer
Parent 2 Phone Number - Will get txts from time to time about Practice & Race information
*
Your answer
Street Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip
*
Your answer
Rider Gender
*
Male
Female
Rider Birth Date
*
MM
/
DD
/
YYYY
Rider Grade Fall 2021 - (NEXT YEAR)
*
Choose
4th
5th
Health Information - please fill in any allergies and health concerns. Example allergy to peanuts, fainting spells, etc.
*
Your answer
Rider Biking Experience Level
*
Your answer
Confidential Information. Information that would be important for the rider's direct coaches to know.
Your answer
Parent Volunteers - Check all possible
Coach - Rider Leader - Parent Ride Along (all skill levels needed)
Daily check in help at start of practice
Basic Volunteer
Bike Mechanic
Submit
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