A-SIG pre-registration form - 2008

  
I wish to participate in A SIG Classic   A-19 SIG
  
First name
Last name
  
Home Phone
Cell Phone
Email
  
Address
City
State
Zipcode
  
Emergency contact
Emergency contact's phone
  
New York Cycle Club member? Yes   No
If yes, how many years?
  
What level club ride have you
typically done up to now?
  
About how many miles per week do you typically ride during the summer?
  
Self-assessment of your riding skills Novice   Moderate  Experienced 
  
What do you hope to achieve in the A-SIG? (Check off one or more)
Better Skills  
Knowledge of Routes
Bike Maintenance
Bike Safety
Strength and Speed
Ride Leader Training
Good Fellowship
General Fitness
  
Medical issues (food or medication allergies, etc.)