Mt. Ascutney "Bike Climb" Registration Form

Sign up for:

$30.00

$45.00

Entry  (day of race)

Name:

Address:

City:

State

Zip Code

Phone

Age

Male


Female


Clydesdale (Men 190 lbs. +)


Filly (Women 140 lbs. +)


For seeding purposes check here if you feel you can finish within 30 minutes.


Method of Payment

Check (payable to "STATE OF VERMONT")

Visa

MasterCard

Register on-line at

Credit Card #:

Exp. date:

Signature

Mt. Ascutney State park "bike climb" | Registration form | Campsite information | Waiver form

MAIL FORM TO:

Mt. Ascutney State Park
1826 Back Mountain Road
Windsor, VT  05089