Please provide the following contact information:
Name Single or Family Registration Please Select One Single Adult Registration Family Registration Single Child Registration Registering as part of a team Team Name if Applicable Street Address Address (cont.) City Province Postal Code Work Phone Home Phone E-mail Notes: Choose your route: Please Select Your Route Route A-100km tour of the Eastern Shore. Route B- Around Two Lakes- 55km Route C- Around the Lake - 38 kms Route D- Half Around the Lake - 18 kms Route E - Social Park Ride Approx Pledges: Please select one $50.00-$100.00 $100.00-$200.00 $300.00-$500.00 $500.00-$750.00 $750-$1000.00 $1000.00 +