CLICK HERE TO REGISTER ON-LINE
To Download our Entry Form in PDF format
Click Here.
To get the free Acrobat Reader
Click Here
(please print this
form through your browser and mail
with souvenir form, check or M.O.
to:
SCOR P.O. Box 9065 • Brea,
California 92822)
Last Name:
________________________________________________
First Name:
____________________________________ Initial: ______
Birthdate:
Month: ___________ Day: ________Year: __________
Address:
_________________________________________________
City:
____________________________ State: _____ Zip: __________
Tel. (home): __________________
Tel. (work): __________________
E-Mail Address:
____________________________________________
Emergency Contact Person:
__________________________________
Tel.:
______________________________________________
Route: (Please
check)
___25 miles
___50 miles ___Metric Century
(63 miles)
(Please
check)
Single Rider ($50.00) ______Tandem Team
($80.00)......$__________
Name of Tandem
Partner:__________________________________
Barbeque Lunch: $13.00 /
person X______people........$__________
Total from Souvenir Order
Form: ..........................$____________
GRAND TOTAL:
......................................$______________
Check or money order must
be postmarked by October 20, 2010.
Ride rain or
shine. No refunds or transfers to other riders or events.
For information or
to volunteer, call (562) 690-9693.
A confirmation card with you
assigned bib number
will be mailed to all registered riders.
Please bring
this card with you to the pre-registration area.
REGISTER ON-LINE HERE
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