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If you'd like to join us on one of our tours, please fill out the form below and click submit. After submitting this form you will be contacted within 48 hours to verify your registration and make payment arrangements.  

Contact Information
Name*		Which trip signing up for	Tour of Flanders Flanders with Gent Extension Paris Roubaix Roubaix with Gent Extension Summer in France
Address 1*		Address 2
City*		State*
Zip*		Country
Primary Phone*		Secondary Phone
Gender*	Male Female	Birth Date*
Email*		Confirm Email*
Medical and Emergency
Name of Emergency Contact*		Emergency Phone*
Relation to you*
Medical Issues or Allergies
Dietary Restrictions
Do you have any physical or mental limitations that may prevent you from participating in this trip?			Yes No
If yes, please specify
Travel Arrangements
Are you booking trip insurance through us or third party?	Us Third Party None	How did you hear about us?	Friend Internet Search Cycling Seminar Bike Shop Cyclocross Magazine Velo News
Method of Payment*	Check Pay Pal	I am traveling alone I am traveling with others
If traveling with others, please list full name(s)
You and Your Bike
Brand/Model bike you're bringing*		Number Years Riding*	1-2 3-9 10-15 16-20 20+
Average Weekly Mileage*	0-20 miles 20-50 miles 50-100 miles 100-150 miles 150-200 miles 250+ miles	Rate your Fitness*	Novice Good Better Best Exceptional
Racing Experience*	Don't Race 1-2 years 3-5 years 5-10 years 10+ years
Policies can be viewed here
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