Registration for 4th Annual Ride for Habitat

June 19, 2010

Ride for Habitat

Wompatuck State Park, Hingham, MA

Download Sponsors Signup Form

Registration fee is $25 per rider.
Deadline for Registrations is June 4, 2010
Please complete the fields below:

Questions marked by * are required. 

After you press SUBMIT at the bottom, you will be taken to a page so that you may pay your registration fee.
1. First Name: *
2. Last Name: *
3. Date of Birth: *
4. Email: *
5. Address *
6. Address2
7. City: *
8. State: *
9. Zip Code: *
10. Phone: *
11. Emergency Phone:
12. Choose Circuit to Ride:
13. Choose LPC for which you will be raising money:
14. Request bike jersey size (bike jersey is free with $300 in donations):
15. Comments: