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Mid-Atlantic Bike Rally & Charity Ride
First Name
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Last Name
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Email Address
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Street Address
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Phone Number
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Address Line 2
City
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State
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
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Church Affiliation:
Bike Club Affiliation
How did you hear about the ride?
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I have participated in an earlier MACU ride
Friend
Biker club
Flyer posted at a business
Saw ad in newspaper/newsletter
Heard radio ad
Announced at church service
Announced at church service
Attendance Details
Please enter the number of bikers/riders below. Enter "0" into any field that is not required.
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🛈
$25 per Bike
$15 Per Passenger
T-Shirt Sizes:
Please, make sure to fill out all of the sizing fields. If you do not need any shirts in a specific size, enter a "0".
Please note: T-Shirt size cannot be guaranteed after 8/23/2014.
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XXL
XL
L
M
S
Please select a payment method (You will be asked to confirm your selection on the next page):
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Paypal
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