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Charity Ride Reservation Form

bike rides

Reservations being accepted for:

Walk or Pedal for PSC

Woodstock, Vermont   July 28-30, 2017

55k or 100k Cycling Challenge or 15k Walking Challenge

A reimbursable $350 deposit is due with registration. Deposits can be paid by check (preferred), online with Visa, MasterCard or PayPal or by phone at 877-545-1864 or 508-545-1864.

Please contact us for event details.

*= Required Information

          

Participant #1:

First Name*:
Last Name*:

Gender: Male | Female


Address and Contact Info:
Street Address*:

City*:
State*:
Zip*:

Country*:

Email*:

Phone*:

How did you hear about Walk or Pedal for PSC?*:

For Cyclists Only

Bike Rental*:


(no charge)
Height in Feet and Inches:

I prefer a bike with:*


- Not Renting

I prefer this pedal type: *






Helmet Rental (no charge)*:

Room Accommodations* (subject to availability):


Name Rider or Guest Additional Charge for Guest (Includes 2 nights lodging, 2 breakfasts & 1 lunch)
2nd Person: $440
3rd Person: $45
4th Person: $45
I would like a room with: |




Non-Participant (Guest) Meals:
_______ dinners at $55 each.






Comments/Clarifications:

Participant #2:

First Name:
Last Name:

Gender: Male | Female


Address and Contact Info:
Street Address:

City:
State:
Zip:

Country:

Email:

Phone:

How did you hear about about ______:

For Cyclists Only

Bike Rental:



Height In Feet and Inches:

I prefer a bike with:



- Not Renting

I prefer this pedal type:





Helmet Rental (no charge):

Room Accommodations (subject to availability):


Name Rider or Guest Additional Charge for Guest (Includes 2 nights lodging, 2 breakfasts & 1 lunch)
2nd Person: $440
3rd Person: $45
4th Person: $45
I would like a room with: |




Non-Participant (Guest) Meals:







Comments/Clarifications:

You will have the opportunity to sign up additional people after clicking "Submit" below.

Payment Information*
(on next screen you will have the option to pay online or be given details on how to send a check.)

Pay deposit and any single supplement or guest fees now with Visa or MasterCard



Event Details and Policies Acceptance* (required)
Check that you have read and understand the Event Details and Cancellation Policy.




Copyright © 2015 Great Freedom Adventures, All rights reserved.


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