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NCC Fall Youth Cycling Series Registration
Please fill this form out once per child. It's good for the entire series. Event details can be found on the
Northampton Cycling Club's
website.
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* Indicates required question
Child's name
Your answer
School grade and name of school
*
Your answer
Age as of today
*
Your answer
Birthdate
*
MM
/
DD
/
YYYY
Pronouns
*
Your answer
Parent/guardian/emergency contact name
*
Your answer
Emergency contact phone number
*
Your answer
Email address for program updates
Your answer
City/town/zip
Your answer
Are you a current member of the NCC?
*
Joining the NCC
is quick and loops you in to all the great youth programming we offer throughout the year. We offer both junior and family memberships.
Yes
No
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