This is the registration form for membership in trailblazers. Please complete as much of the information as you can. If you have any problems, send an email to info at trailblazerstandem dot o r g. By the way, this field is just so we can give you these instructions as Google Forms does not always play nice with screen readers. Just tab to next field and start with First Name.

Enter your first name

Enter Last Name

Enter Street Address and include unit or apartment number

Enter City

enter Province. optional unless not in ontario

What is your Postal Code

Enter Primary phone number. Cell Phone number is preferred. Enter digits and hyphens (e.g. 647-555-5555).

Is this number capable of receiving text messaging? Answer yes or no.

If applicable, enter an alternate phone number here. Please enter digits and hyphens (e.g. 647-555-5555).

Enter your email address

This is another fake field so zoom text will read the description of this field. Below are check boxes for our five sheds. Select as many as you like. Tab to first field which is CNIB. By the way, JAWS correctly indicates whether box is checked, Zoom text not so good so look carefully.

enter "yes" or "no" whether you have ridden a tandem before

Enter "yes" or "no" whether you also own your own tandem

Please tell us if you are able to volunteer for the club Enter yes, no or leave blank if you're not sure right now.

If yes, what skills could you contribute to the club?

Emergency Contact Name

What relationship is the above person?

Emergency Contact Phone Number. Please enter digits with hyphens (e.g. 647-555-5555).

Is there an alternate contact we could call?

If applicable, please enter the phone number for your alternate emergency contact. Please enter digits with hyphens (e.g. 647-555-5555).

This is another fake field so zoom text will read the description of this field. Below are check boxes for our five sheds. Select as many as you like. Tab to first field which is CNIB. By the way, JAWS correctly indicates whether box is checked, Zoom text not so good so look carefully.

CLICK HERE FOR CNIB SHED AT BAYVIEW AND EGLINTON

NEAR KENNEDY SUBWAY

NEAR BAY AND QUEENS QUAY

NEAR BURNHAMTHORPE RD. E. AND HURONTARIO ST.

NEAR ROYAL YORK AND LAKESHORE

NEAR BURNHAMTHORPE AND WEST MALL

Another description only field. Help us understand what time of day and week you think you will do much of your riding. Options are days, evenings, or weekends. Select any or a combination that best describes what riding you think you will do. You are never restricted to just these times. Tab now to next field.

Click if you think you will ride mostly during the day monday to friday

Click if you think you will ride mostly during the EVENINGS

Click if you think you will ride mostly during the weekends.

Are there Health conditions we should be aware of? (e.g. epilepsy, diabetes, Asthma, etc.) PLease enter yes or no.

If yes, please explain briefly. You may talk to us later.

Membership in TRAILBLAZERS is fifty dollars. Sending an E M T to treasurer@trailblazerstandem.org is preferred. Please email us for instructions if you have questions. You may also mail a check to TRAILBLAZERS, care of, Simon Berkowitz at 1 8 9 Montclair Ave. Toronto. Ontario. M 5 P 1 R 1. Tab to next field.

We will be in contact with you. Please remember that we will need an original, signed copy of our Waiver Form to be submitted via email to the address shown at the bottom of the waiver, (found here on our site), or provided to us at the time of the Orientation session. Tab to next field.

Contrary to what Google forms is saying, comments are optional. Complete as desired and tab to "submit" button. thank you.