DistanceRider

• Facebook

Rider Info

Finger Lakes Randonneurs
Central and Western NY Region
Rider information for regular events

Please be accurate. This information will be used to automatically pre-print your waiver and brevet card, and to mail back your brevet card. What you enter is exactly what will be used. Note: For security reasons, none of this data is held on line Any questions, contact me!

When you hit "Send" at the bottom of this form the information is e-mailed directly to the RBA, and a copy to you. After I've verified RUSA membership, I'll send you a confirmation e-mail with further information. If you don't have a response from me within a few days, please contact me!!

First Name

Last Name

Street Number Street City State/Province (2 letter abbreviation) Zip/Postal code RUSA # (mandatory) RUSA membership is mandadory!! Your E-Mail Address Home Phone Cell number during ride Emergency contact name(s) Emergency contact phone number(s) Anything else you'd like me to know?

When you click "SEND" an e-mail will be sent to me with this information, and I'll add you to my database. Once I've done that, I'll e-mail you a confirmation.

This site uses cookies to store your map viewing preferences.

Accept and dismiss this message.I don't want cookies.