Personal Information Form

Name *

First Name

Last Name

Phone *

(###)

###

####

Bike Brake Type *

Disc Brake

Rim Brake

Gender *

Female

Male

Non-gender Specific

Date of Birth *

MM

DD

YYYY

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Name *

First Name

Last Name

Number *

(###)

###

####

*

Email/ Newsletter

Website

Saw Kit

Saw Centre

Social Media

Word of Mouth - from (below)

Terms and Conditions *

I acknowledge that the information supplied on this form is correct at the time of completion. I will update this information with the Head Coach should my circumstances change. I have read the terms of the current Cams Cycling Collective terms and conditions and agree to the same.

Agree