CBC Racing - Olympia Orthopaedic Associates Cycling Team - 2016
Welcome cyclists! Thanks for helping us collect information about you during the registration process for the CBC Racing / Olympia Orthopaedic Associates Cycling Team 2016 race year.

NOTE: If you would like to apply for membership by paper copy or if you are under 18 and would like to join you must complete your registration by mail as a parent/guardian signature is required. Please print out the pdf application form found here: https://drive.google.com/file/d/0ByhBY4K5OC3LbVg3b3ByZW1nU00/view?usp=sharing

If you encounter any problems with this form, please email me directly for assistance: apeasley3@gmail.com

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Birthdate *
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Gender *
Email *
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Street Address 1 *
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Street Address 2
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City *
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State *
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Zip *
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Contact Phone # *
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Emergency Contact Name *
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