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2017 Global Relay Bridge the Gap BC Youth Super Week Sign Up Form
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* Indicates required question
Name
*
Your answer
Contact email
*
Your answer
Gender
*
Boy
Girl
Birth Year
*
Girls born in 2001, 2002, 2003 and 2004. Boys born in 2002, 2003, and 2004
2001
2002
2003
2004
Club or Team
*
Indicate N/A if none
Your answer
Races I would like to enter
*
July 8 - Tour de Delta Brenco Criterium
July 11- New West Grand Prix Criterium
July 12 - Global Relay Gastown Grand Prix Criterium
July 13 - Giro di Burnaby Criterium p/b Appia Development
July 14- PoCo Grand Prix
July 15 - Tour de White Rock Criterium
Required
Emergency Contact Information
*
Name, relationship, phone number.
Your answer
I need host housing.
YES
NO
Clear selection
If "Yes" to host housing please describe your need
eg dates, number of people, etc
Your answer
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