Registration Form
One person per form, please. Form may be duplicated—but be sure to duplicate and sign the Release Form on the back. (click link to open page)
PLEASE PRINT
Name: _________________________________________________
Street: _________________________________________________
City, State, Zip: __________________________________________
Phone: _______________________ Age: _________ Sex: ________
Email: _________________________________________________
Emergency Contact: ______________________________________
Emergency Phone: _______________________________________
T-shirt Size: S M L XL
(T-shirts available while supply lasts!)
Ride Choice:
Entry Fee: _________
$25 if postmarked by September 22
$30 if postmarked after September 22
$10 for Kids fun ride
Make checks payable to TCRC and send to:
TCRC
P.O. Box 5021
Johnson City, TN 37602-5021
OR - Register online at:
75
