Sharon's Ride Hawaii - Keiki Bicycle Obstacle Course and Ride

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Thank you for your interest in participating in the Sharon's Ride Keiki Bicycle Obstacle Course.This event will take place on January 25th, 2015 at Kapiolani Community College at 10:30 am. Please visit epilepsyhawaii.org/srrw/keikibike for details.

Your child will receive a helmet fitting and bicycle check up.
Your child must have a bicycle helmet to participate. A limited supply of free helmets will be available for those without an adequate helmet provided The Queen's Medical Center.

If you wish to sign up more than one child please fill out this form once for each child.

Child Name *

Gender *

Boy

Girl

Required

Age *

Riding Level *

Child's Riding Ability

Tricycle

Training Wheels

On two wheels for less than one year

On two wheels for more than one year

Required

Parent contact phone number *

In case we have to contact you the morning of the event

Parent contact e-mail address *

Helmet *

Does your child have a helmet?

My child will bring a helmet to the event and will have his/her helmet inspected.

My child would like to make a donation to ThinkFirst Hawaii to receive a helmet (suggested donation $10).

My child does not own a helmet and I am not able to buy a helmet at this time (retail $25). Therefore, I am requesting a FREE, brand new helmet.

Required

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