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2024 Capital Bike Club Membership Form
First Name *
Last Name *
Email *
Password *
Confirm Password *
Country *
Address *
City *
State *
Zip Code *
Phone *
Emergency Contact *
Emergency Phone *
Date of Birth - Must be 21 or over to join *
Waiver *
I have read and agreed to the TERMS *
Click here to view the TERMS.
Is the participant 18 or older? *
  18 or older       Under 18
Payment Details
Discount or Tracking Code
 
Apply
Do not COPY & PASTE the code, please type it into this field.
Price
$
Discount (-)
$
Handling
$
Total Owed
$


Payment Method
Visa/Mastercard
Amex Card
Check
Credit Card #
Postal Code
Exp. Date  
/
CVV Code
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