Heatstroke 100 Registration 2024

"*" indicates required fields

Hidden

Admin Only Fields

Change these fields to affect the logic within the form. Hidden fields can still be used in conditional logic. Set prices on in the "Registration Type" fields below.

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Early Registration Cutoff Date

Change the default date under Advanced > Default to set the early registration cutoff.

Registration Form

Early registration ends on August 24th, 2024. Early registration fee is $50 for individuals and $80 for families through August 24th. After that, the fee increases to $60 for individuals and $90 for families.

Rider's Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Email*

Phone*

Privacy Notice

Your e-mail addresses will be kept on the Club’s membership list, which is shared with other members from time to time, but which will not be made available on the website or shared with the general public by the Board.

Registration Details

Ride Registration Type*

Individual - $60.00

Family - $90.00

Early Registration Type*

Individual - $50.00

Family - $80.00

Add Additional Family Members*

Please provide the names of all the additional family members planning to ride (we want to recognize all riders plus we need the information for food supply purchases). Click the plus sign to add more rows if needed. Please do not include yourself again.

First

Last

Phone

This field is for validation purposes and should be left unchanged.

Heatstroke 100 2024

Admin Only Fields

Registration Form

Privacy Notice

Assumption of Risk / Release of Liability

Registration Details

Heatstroke 100 Registration 2024

Admin Only Fields

Registration Form

Privacy Notice

Assumption of Risk / Release of Liability

Registration Details

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Register