Signup Form - St Croix Valley D-Team 4th - 6th graders (fall 2017)
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 also) If you don't wish to pay online please contact us at stcroixcycling@gmail.com
Rider First Name
Your answer
Rider Last Name
Your answer
Rider Email Address
Your answer
Parent 1 - Email Address
Your answer
Parent 1 - Name (First Last)
Your answer
Parent 2 - Email Address
Your answer
Parent 2 - Name (First Last)
Your answer
Rider Phone Number - Will get txts from time to time about Practice & Race information
Your answer
Parent 1 Phone Number - Will get txts from time to time about Practice & Race information
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
Rider Birth Date
MM
/
DD
/
YYYY
Rider Grade Fall 2017 - (NEXT YEAR)
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
Your answer
Parent Volunteers - Check all possible
Submit
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