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TCLOSED: Manzo Bike Club Registration
Bike Club is no longer taking new riders. Contact juliana@elgrupocycling with any questions
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Email
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Your email
The Monday/Thursday Bike Club has filled up. Please select the Tuesday/Friday option. If you're unable to make Tuesday/Friday please choose "Have Colter contact me" and we will figure out a plan. Thanks!
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Tuesday/Friday
Participant name
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Your answer
Date of birth
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MM
/
DD
/
YYYY
Age
Your answer
Parent/Guardian Information
***2 Adult contacts required
Parent/Guardian #1 Name
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Your answer
#1 Relationship to participant
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Your answer
#1 Address
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Your answer
#1 City, State, ZIP
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Your answer
#1 Cell Phone
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Your answer
#1 Email
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Your answer
Parent/Guardian #2 Name
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Your answer
#2 Relationship to participant
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Your answer
#2 Address
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Your answer
#2 City, State, ZIP
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Your answer
#2 Cell Phone
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Your answer
#2 Email
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Your answer
When we apply for grants we are often asked to provide demographic information about your participants. Please help us ensure that we receive as much grant funding as possible by providing the following information:
What is the participant's race/ethnicity?
White/Caucasian
Latino/Latina/Hispanic
Black/African American
Native American
Other:
Clear selection
What is your total household income?
$0 - $25,000
$25,001 - $50,000
$50,001 - $75,000
$75,001 - $100,000
$100,001 - $125,000
$125,000 or more
Clear selection
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