iCan Bike Rider Registration Form
This program is currently FULL. Complete this form to add your rider to the waiting list. You will be contacted by the Host Organization regarding the status of your rider’s registration.

Requirements for Participation (Rider must meet all of below criteria):

· Minimum age - 8 years old
· Able to sidestep to both sides
· Have a disability
· Able to attend camp all 5 days
· Able to walk without assistive device
· Maximum weight 220 lbs.
· Willing and able to wear a properly fitted bike helmet
· Minimum inseam of 20” (measure from floor while rider is wearing sneakers)

NOTE: Dropping-off Riders at the program is not permitted. A parent, legal guardian or other adult authorized to take responsibility for the Rider (e.g. another parent) must remain on site for the duration of the 75-minute program.

Camp host: Variety - the Children's Charity of Texas
Camp dates: July 8, 2019 - July 12, 2019
Camp location: Clay Madsen Recreation Center 1600 Gattis School RD, Round Rock, TX 78664
Fee: $150.
For questions please contact Ruthie Hanna at ruthie.hanna@varietytexas.org

Next
Never submit passwords through Google Forms.
This form was created inside of iCanShine. Report Abuse - Terms of Service