Please fill out this form if you're planning to ride or walk on Thursday, May 15th as your means of transportation to work, school, or wherever you need to go! Registering makes you eligible for prizes and helps us log miles cycled or walked in Western Nevada County.

Please provide the following contact information:

Full Name
Organization
Street Address
City
State/Province
Zip/Postal Code
Work Phone
Home Phone
E-mail

Destination(s) on Thursday, May 15th 2008

Mileage

Route Description

How long have you been bicycling to work or school?

How often do you ride per month on average?

Why do you like using your bicycle for transportation?

Any additional comments


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Revised: 04/21/08