Bike to Work - Bike Shop Registration 2010
Exit this survey

1. Bike to Work - Bike Shop Signup

1. Business Name:

Business Name:

2. Address:

Address:

3. Hours of Operation:

Hours of Operation:

4. Phone:

Phone:

5. Fax:

Fax:

6. Contact Person:

Contact Person:

7. E-mail:

E-mail:

Confirming the agreement below indiciates a commitment to be a Participating Bike Shop for Northern Nevada Bike to Work Week. Participating Bike Shops will be listed on the event website.

*
8. This commitment includes:

I would like to be a Participating Bike Shop:

This commitment includes: I would like to be a Participating Bike Shop: My shop will hang posters and provide postcards to customers.

My shop will provide free bike "Safety Assessment" to anyone that mentions Bike to Work Week 2010. A Safety Assessment includes a bike inspection to determine use-ability and safety, but does not include actual remedy and/or repair of the bicycle. This will also include a helmet fitting.

My shop will provide safety clinics on topics related to commuting safety and bicycle maintenance & repair. Topics, times, and locations will be provided to the Bike to Work Committee by April 15th 2010.

My shop will become a Bike to Work Week 2010 sponsor.

*
9. Name of Person Completing Form:

Name of Person Completing Form:

*
10. I am authorized to make this commitment on behalf of this business.

I am authorized to make this commitment on behalf of this business. Yes

11. Why are you participating in Bike to Work Week 2010?

Why are you participating in Bike to Work Week 2010?

12. Other comments:

Other comments:

Bike to Work - Bike Shop Registration 2010Exit this survey