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Kids Pedal in the Park

Kids Pedal in the Park Registration Form

Rider 1 Name*
First Last
Rider 1 Age*
Age on day of event (July 29, 2023)
Please enter a number from 7 to 12.
Rider 2 Name
First Last
Rider 2 Age
Age on day of event (July 29, 2023)
Please enter a number from 7 to 12.
Rider 3 Name
First Last
Rider 3 Age
Age on day of event (July 29, 2023)
Please enter a number from 7 to 12.
Rider 4 Name
First Last
Rider 4 Age
Age on day of event (July 29, 2023)
Please enter a number from 7 to 12.
Parent/Guardian Name*
First Last
Parent/Guardian Phone*
Parent/Guardian Email*
Enter Email Confirm Email
Parent/Guardian Address
Street Address Address Line 2 City State ZIP Code
Secondary Emergency Name*
In the event the parent/guardian cannot be reached, please provide an additional contact name.
First Last
Secondary Emergency Phone
Number of Riders*
Choose the number of riders
RELEASE OF ORGANIZERS AND SPONSORS
By completing and submitting this registration you hereby release TEAM Punta Gorda, Charlotte Harbor Environmental Center (CHEC), volunteers, directors, and sponsors from any and all claims, damages, personal injury, and forever waive the right to sue for any alleged negligence. As the parent/guardian you assume the risk involved in bicycling, agree that all riders in your care will wear a helmet at all times, follow all event rules, and recognize that bicycling may involve hazards. I also consent and agree to the disclosure and use of rider first names and pictures for TEAM Punta Gorda and CHEC publications.
Total Price
Total
Total of your purchase
$0.00

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227 Sullivan Street
Punta Gorda, FL 33950

941.637.TEAM (8326)
TEAM@teampuntagorda.org