MECCA Bicycle Club
             
Spring Festival
May 3, 4, 5, 2019
 
Participant Registration, includes guided rides on Saturday and Sunday, light snack Friday night and dinner Saturday night.               
Registration after April 19th will increase to $85.

Amount:     Quantity:    
Participant's First and Last Name [1]
Gender [1]
Sport-Tek Shirt Size [1]
Age [1]

Participant's First and Last Name

[2]
Gender [2]
Sport-Tek Shirt Size [2]
Age [2]

Participant's First and Last Name

[3]
Gender [3]
Sport-Tek Shirt Size [3]
Age [3]

Participant's First and Last Name

[4]
Gender [4]
Sport-Tek Shirt Size [4]
Age [4]

Participant's First and Last Name

[5]
Gender [5]
Sport-Tek Shirt Size [5]
Age [5]

Participant's First and Last Name

[6]
Gender [6]
Sport-Tek Shirt Size [6]
Age [6]

Participant's First and Last Name

[7]
Gender [7]
Sport-Tek Shirt Size [7]
Age [7]

Participant's First and Last Name

[8]
Gender [8]
Sport-Tek Shirt Size [8]
Age [8]

Participant's First and Last Name

[9]
Gender [9]
Sport-Tek Shirt Size [9]
Age [9]

Participant's First and Last Name

[10]
Gender [10]
Sport-Tek Shirt Size [10]
Age [10]
($75.00 per person, after April 19 it is $85.00)
 
               Guest Meals, includes only meals - no guided rides, shirt, prize, etc - for guest(s) of participants.
Children 10 years old and under eat free.
Meal Only:     Quantity:    
($15.00 per meal, after April 19th it is $20.00)
T-Shirt(s):   $10.00   Quantity:   Item Subtotal:  
$0.00
Sport-Tek Shirt Size(s) [1]

Sport-Tek Shirt Size(s)

[2]

Sport-Tek Shirt Size(s)

[3]

Sport-Tek Shirt Size(s)

[4]

Sport-Tek Shirt Size(s)

[5]

Sport-Tek Shirt Size(s)

[6]

Sport-Tek Shirt Size(s)

[7]

Sport-Tek Shirt Size(s)

[8]

Sport-Tek Shirt Size(s)

[9]

Sport-Tek Shirt Size(s)

[10]
 
PROMO Code
 
Total:
$0.00
 
Registrant's Information
First Name: Last Name:
Address:
Address:
City: State/Province: ZIP/Postal Code:
Phone: Email:
 
EMERY COUNTY RECREATION PROGRAMS WAIVER FORM
Please read the following waiver form and check the appropriate box(s) at the bottom.


Participant
I have read, understand, and agree to the AWRL Waiver.
*If participant is under the age of 18
Please list name of parent/guardian completing this form.

Payment Information
Method of Payment:
Processing Fees: Credit cards: 2.9% plus $0.30
eChecks: $0.49
Update name from Registrant's Information
Name of Individual
on Checking Account:
Name of Individual
on Savings Account:
Name of Business
on Checking Account:
Bank Routing Number:
Bank Account Number:
Confirm Account Number:
Credit Card Number: (Type number or swipe with cursor in this empty field)
Expiration Date: /
Card ID (CVV2/CID) Number: What is the Card ID?
Cardholder Information (exactly as it appears on your statement)
  Update from Registrant's Information
Cardholder's Name:
Billing ZIP/Postal Code:
By submitting this form, you have completed the necessary paperwork
to participate in the event.
You must mail a check for the participation fees to the address below.


For assistance, call 800-764-0844

 
MECCA Bicycle Club
P.O. BOX 491 - Huntington, UT 84528-0491
meccabikeclub@etv.net
Website - biketheswell.org
 
 
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