Bikers for Babies - Register to ride

BIKERS FOR BABIES INFORMATION:
Event Name: Bikers for Babies
Date: 8/7/2010
Time: 10:00 AM
Location: Sherburne, NY

START LOCATION:
Gilligan's Island
64 North Main Street
Sherburne, NY 13460

END LOCATION:
Jamesville Beach Park
4110 West Shore Manor
Jamesville, NY 13078

Change Bikers for Babies location

* required fields

Rider Status:*

Rider - $25 Passenger - $25

You will have the opportunity to register another participant once you complete your registration.

Fundraising Goal for Bikers for Babies 2010 *

$ (No commas, please.)

Title

First Name*
Last Name*

Address One*
Address Two

City*
State*

Zip*
- Phone
- -

E-mail*
Re-type E-mail*

NOTE:
We require an e-mail address so that we may send you a confirmation.
We will not share this e-mail address with any third party.

Username*

Important! This username will be the address of your web page, and cannot be changed later
(e.g. www.Bikers for Babies.org/username)

Password*
Re-type Password*

Password Hint*

NOTE:
Without your password hint, we will not be able to assist you if you forget your password.

Brand of Motorcycle You're Using for Bikers for Babies:

Group You'll Be Riding With (if any):

My T-shirt preference (sizes may vary by Bikers for Babies site)
Size:

S M L XL XXL Other

Gender:

M F

Age

Payment Type*

Credit Card PayPal Cash or Check

* required fields

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