Program name and date 

Official Name   Nickname

Nationality   
Passport   #
Issued at     Exp. date   

Sex    Age    Height   Weight
Birthday  Place of Birth

Occupation  

Address1    
Address2    
City        
State/Prov     Zip/Postal Code
Country     
           
Tel. Day     
Tel. Evening
Fax         
best hour to receive telephone calls 

E-mail      

In Case Of Emergency Notify: 
Name          Relationship
Tel         
Address     

Air Travel Arrangements: Unless specified otherwise air reservation and ticketing for your trip will not be handled by  Ibike.   Our travel agents knowledge of schedules, fares and routings to the destination assures you excellent service. It is usually to your advantage to combine domestic and international ticketing together.

I will book my own air travel.
Arrange air transport from and returning to
Class of service: First  Business  Economy  
Preferred airline(s):
Arrange the following diversion from group air schedule (please be specific about dates, route,  stopovers, extended travel, etc.)

My bicycling experience:

My overseas experience:

My current level of physical activity:

Special interests: I would especially like to see or learn about....

Dietary restrictions, allergies, special medications or other personal needs:

I first heard about this program through

And, my T-shirt size is: small   medium  large  x-large

Other questions and/or comments:

Note: THIS PAGE HAS SOME IDIOSYNCRASIES.  It works for us with both IE and Firefox, but hangs up for other folks.  If, when you submit the form, and you don't get a "thank you" message, hit the back button, turn off your cookie control and submit the page again. (We can't explain why this is because we doesn't use cookies or track movement in any way.)  Seeing the "thank you page" seems to be the best indicator that the application is working, but not a sure thing because often we get the form even when people don't get the "thank you page" -- go figure.

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