Mail Registration to:

River City Cycling Club
P O Box 295
Elizabeth City, NC. 27907-0295

*Make checks payable to RCCC - $35.00 adult, $20.00 youth (under 16, must be accompanied by an adult)

No confirmation will be sent.

For additional info call Jeri at (252) 339-0660 (6:00 pm to 10:00 pm) or Cycle Gallery at (252) 338-1559 ( 9:00 am to 6:00 pm)

Name: ______________________________________________________________________

Address: ____________________________________________________________________

City: _______________________________________________________________________

State: ______________________________________ Zip: ___________________________

Phone number: _______________________________________________________________

Emergency contact: ___________________________________________________________

Emergency contact phone: _____________________________________________________

 

I plan to ride the: Third Century (33) - Metric Century (62) - English Century(100)

T-Shirt Size:  S    M    L    XL    XXL     No T-shirt

The T-shirt is guaranteed only if your registration is post-marked prior to April 4, 2008.

If under 18, have parent sign for permission. Riders under 16 must be accompanied by an adult.

River City Cycling Club requires a waiver must be signed prior to ride. Please sign below agreeing to do so.

Signature/Date ____________________________________________________________

Guardian if required ________________________________________________________