BikeEd 2007 Registration

Your Information
First Name:
Last Name:
Address:
Address 2:
City:
State:
Zip:
Country:

Cell Phone:
E-Mail:
Organization:
Position:
LCI # (if applicable):
Registration Fees
League Member	$350
Membership No. (not required)
Non-Member	$425
LCI	$325
Special Dietary Needs:
If you have other special needs, please explain: Please note: We cannot guarantee that all needs will be met. In order to better facilitate your request, please return this response to us no later than, Monday, May 14, 2007.
T-shirt size:

Payment and Details
Payment Method:
Total Amount ($ US):
Credit Card Number:
Expiration Date:	/
Card Holder's Name:
	Click the button below to submit your registration. Do not click the button more than once. Doing so, may result in duplicate charges. Please note: $50 administrative fee for any cancellations prior to 6/01/07. No refunds after 6/01/07

Learn how to ride your bike safely and confidently through a BikeEd course from the League of American Bicyclists.

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