Scenic Shore 150 Bike Tour Dropped Rider Form

General Participant Information

First Name *

Last Name *

Birthday *

Male

Female

Address *

City *

State *

Zip *

Email Address *

Preffered Phone Number *

Alternative Phone Number

Date Of Drop *

Reason For Dropping *

Medical

Personal

Unable to Fundraise

Other Other

If you are unable to attend the in person event would you like to participate in the virtual event? *

Comments

Signature *

clear

New Rider Name

Phone Number

Email Address

***Riders will not be dropped from the Scenic Shore 150 Bike Tour until this form is received by our office.

All riders who submit a dropped rider form will receive confirmation from our office.