A Christian Retreat Center and Summer Camp
located in Lancaster County, PA

2010 Bike-A-Thon Registration Form

To register for the 2010 BR2RB Bike-a-Thon, please fill out the following information:

First Name:     Last Name:  

Street:       

City:               State:   Zip:

Home Phone:    Cell Phone:    Work Phone: 

E-mail Address:  

Age:

I plan to ride:

Jersey Size (If registering before July 2nd):

Male:     Female:

Small:    Medium:    Large:    X-Large:  

How did you hear about this ride?: