Name:

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* 1. Name:

E-Mail:

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* 2. E-Mail:

Telephone:

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* 3. Telephone:

City:

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* 4. City:

Bike Skill Level:

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* 5. Bike Skill Level:

Reason I ride (select all that apply):

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* 7. Reason I ride (select all that apply):

I prefer a class:

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* 8. I prefer a class:

I have interest in the following classes:

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* 9. I have interest in the following classes:

Other interests and comments

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* 10. Other interests and comments

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