Tour de Midlands Registration |

Name:

Address:

City:

State: Zip Code:

Home Phone:

Email Address:

Route you intend to ride: 15 30 72 102

T-Shirt Size: Small Medium Large X-Large XX-Large

Postmarked By 5/03/11 - $30

Postmarked After 5/04/11 - $40

I understand that an approved bicycle helmet must be worn while participating in this event. A waiver must be signed when I sign in for the ride before I will be allowed to participate in the Tour de Midlands. If particpant is under the age of 18 years, a parent or guardian must sign the required waiver.

Age:

Name: Date:

Click on DONATE to pay by credit card or mail your complete registration form with your check payable to:

Community Open Land Trust
P.O. Box 1605
Lexington, South Carolina 29071

 

Presented by:

Community Open Land Trust
for
Lexington Greenways Alliance

For more information on Colt and LGA please go to |
www.communityopenlandtrust.org

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