KFCCC

RIDER APPLICATION

The $50.00 per person fee applies whether or not each
person participates in the ride, as the fees cover
each person's meals, insurance and any other expenses.

Fields marked with an * are required.

Check or Money Order should be made out and sent to:

Kevin Foster
PO Box 72
Kaweah Commonwealth
California 93237

Your information WILL NOT be sold or given to ANY third party.

The FIRST 50 registered will receive a FREE...
T-SHIRT and OTHER SCHWAG from the event!
(a $50.00 value)

When making final payment, please specify which ride route you wish to do.

Main Rider Information
First Name: *
Last Name: *
Address Street 1: *
Address Street 2:
City: *
Zip Code: *	(5 digits)
State: *
Spouse - Partner - Friend Information
First Name:
Last Name:
Contact Information
Daytime Phone: *
Evening Phone: *
Email: *
Children - Whether Participating in Ride or Not (must be at least 13 and older to join ride)
Child 1, First & Last Name; Age:
Child 2, First & Last Name; Age:
Child 3, First & Last Name; Age:
Child 4, First & Last Name; Age:
Emergency Contact Information
First & Last Name: *
Contact Phone Number: *
Payment & Additional Comments
Payment (per person):
Number of People: *
SPECIFY	Short Road Bike Route
WHICH	Long Road Bike Route
ROUTE	Mountain Bike Route
Total Amount: *
Comments:	Don't wish to sign up via the internet? No problem. Just print out this form, and send it in with your payment no later than August 31.