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Millbrook MTB – Youth Registration
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Member Name
*
First
Last
Member Email
*
Phone Number
*
Emergency Contact
*
Emergency Contact Phone Number
*
Rider's Date of Birth (optional)
Number of years active in mountain biking
Activities & Interests (Check all that apply)
Group Rides
Youth Events
Skills Clinics
Social Events
Trail Builds
Trail Maintenance
Just want to ride!
Social Media Waiver
*
I agree and give my permission
I prefer to stay private
I give the Millbrook MTB here permission to post images of riders from throughout the season / events / clinics / group rides.
I agree to the following charge
*
Registration Fee - $20.00
Waiver
*
When form is complete, I will receive a confirmation email with a link to complete the mandatory waiver
Proceed to Checkout
You are donating to :
Millbrook MTB
How much would you like to donate?
$5
$10
$30
Would you like to make regular donations?
I would like to make
one time
weekly
monthly
yearly
donation(s)
How many times would you like this to recur? (including this payment) *
2
3
4
5
6
7
8
9
10
11
12
Name *
Last Name *
Email *
Phone
Address
Additional Note
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