Registration for Wediko's 3rd Annual Century Ride Survey

You are registering for the 3rd Annual Wediko Century Ride. The ride is a 100-mile* bike ride from Wediko's New Hampshire campus to our Boston office. All proceeds will be directed towards the "greening" of Wediko, including the redevelopment of hydropower on the Wediko dam of Black Pond.
All participants are required to raise a minimum of $1000, but don't worry- we're with you every step of the way!

DATE: Saturday, September 11, 2010 (dinner/lodging available on Friday, Sept. 10 in NH)
LOCATION: Start at Wediko's NH campus in Windsor, NH and finish at Wediko's Boston office (*there are also shorter routes available)

*
1. Please enter the required information below

Please enter the required information below Name:
Address:
Address 2:
City/Town:
State:
ZIP:
Cell phone:
Email Address:
Home or work number:

2. Your sex?

Your sex? Female

Male

3. What is your affiliation to Wediko and how did you hear about the ride?

What is your affiliation to Wediko and how did you hear about the ride?

4. All riders will receive a cotton Wediko Century Ride tshirt. Please indicate your tshirt size below (sizes are unisex).

All riders will receive a cotton Wediko Century Ride tshirt. Please indicate your tshirt size below (sizes are unisex). small

medium

large

xlarge

xxlarge

*
5. All riders will also receive a cycling jersey, made of technical fiber. Please indicate your size below. (Please keep in mind that these jerseys are typically worn as close-fitting garments. If you would prefer a looser fit, please order a larger size)

All riders will also receive a cycling jersey, made of technical fiber. Please indicate your size below. (Please keep in mind that these jerseys are typically worn as close-fitting garments. If you would prefer a looser fit, please order a larger size) I already have a jersey and would like to donate this year's back to Wediko

women's xxx-large

men's x-small

men's small

men's medium

men's large

men's x-large

men's xx-large

men's xxx-large

women's x-small

Women's small

women's medium

women's large

women's x-large

women's xx-large

6. How do you plan to get to the start (Wediko's campus in Windsor, NH)?
(If you are not sure, please give us your best guess. You can change your plan up until two weeks before the event)

How do you plan to get to the start (Wediko's campus in Windsor, NH)? (If you are not sure, please give us your best guess. You can change your plan up until two weeks before the event) My own transportation, Friday night

My own transportation, Saturday morning

Transportation provided from the Boston office on Friday afternoon

7. Where is your 'homebase'- i.e. Where would you ultimately like to be after the event? (There will be limited transportation available back to Wediko NH on Saturday evening)

Where is your 'homebase'- i.e. Where would you ultimately like to be after the event? (There will be limited transportation available back to Wediko NH on Saturday evening) Wediko campus in Windsor, NH

Boston

8. Will you need accomodations at Wediko NH on Friday night?

(If you know Wediko, then you know that the accomodations provided can be considered 'rustic.' Also, guests would need to provide their own towel, toiletries, pillow & bedding/sleeping bag)

Will you need accomodations at Wediko NH on Friday night? (If you know Wediko, then you know that the accomodations provided can be considered 'rustic.' Also, guests would need to provide their own towel, toiletries, pillow & bedding/sleeping bag) No

Yes

If yes, for how many?

*
9. How many miles do you plan to ride?

How many miles do you plan to ride? 25

100

10. This event's success is dependent not only on our riders, but on our volunteers as well!
Do you know someone who would like to volunteer the weekend of the event? Please pass along their name and email or phone number so that we can contact them!

This event's success is dependent not only on our riders, but on our volunteers as well! Do you know someone who would like to volunteer the weekend of the event? Please pass along their name and email or phone number so that we can contact them! No

Yes

Please include his/her name and contact information. Thank you

*
11. Please give us your emergency contact information.

Please give us your emergency contact information. Name:
Relationship:
City/Town:
State:
Cell Phone Number:

*
12. I understand that by registering and agreeing to ride in Wediko's 3rd Annual Century Ride on September 11, 2010, I am agreeing to raise a minimum of $1000 for Wediko. (Don't worry- we will support you every step of the way! You will also have access to on-line giving. Please contact Kate Patton Regal if you are concerned at any time about your ability to fundraise- kregal@wediko.org)

I understand that by registering and agreeing to ride in Wediko's 3rd Annual Century Ride on September 11, 2010, I am agreeing to raise a minimum of $1000 for Wediko. (Don't worry- we will support you every step of the way! You will also have access to on-line giving. Please contact Kate Patton Regal if you are concerned at any time about your ability to fundraise- kregal@wediko.org) Yes

2010 Wediko Marathon team members and participants in high school or college have a different fundraising requirement. Please indicate if either applies to you.

13. Thank you, you are about to complete your registration for the 3rd Annual Wediko Century Ride. We will be in touch shortly to help you get started with fundraising and training!
In the meantime, if you have any questions or concerns, or would like information about sponsorship packages for this event, please contact Kate Regal at kregal@wediko.org or 617-292-9200.

Thank you, you are about to complete your registration for the 3rd Annual Wediko Century Ride. We will be in touch shortly to help you get started with fundraising and training! In the meantime, if you have any questions or concerns, or would like information about sponsorship packages for this event, please contact Kate Regal at kregal@wediko.org or 617-292-9200.

Registration for Wediko's 3rd Annual Century Ride

1. Wediko's 3rd Annual Century Ride

*1. Please enter the required information below

2. Your sex?

3. What is your affiliation to Wediko and how did you hear about the ride?

4. All riders will receive a cotton Wediko Century Ride tshirt. Please indicate your tshirt size below (sizes are unisex).

*5. All riders will also receive a cycling jersey, made of technical fiber. Please indicate your size below. (Please keep in mind that these jerseys are typically worn as close-fitting garments. If you would prefer a looser fit, please order a larger size)

6. How do you plan to get to the start (Wediko's campus in Windsor, NH)? (If you are not sure, please give us your best guess. You can change your plan up until two weeks before the event)

7. Where is your 'homebase'- i.e. Where would you ultimately like to be after the event? (There will be limited transportation available back to Wediko NH on Saturday evening)

8. Will you need accomodations at Wediko NH on Friday night? (If you know Wediko, then you know that the accomodations provided can be considered 'rustic.' Also, guests would need to provide their own towel, toiletries, pillow & bedding/sleeping bag)

*9. How many miles do you plan to ride?

10. This event's success is dependent not only on our riders, but on our volunteers as well! Do you know someone who would like to volunteer the weekend of the event? Please pass along their name and email or phone number so that we can contact them!