CAMP INFORMATION (WAIT LIST)

Camp name: Canmore, AB
Camp date: Saturday-Sunday, August 17-18, 2014
Price: $339 CAD
Dirt Series Camp Wait List

You are requesting to be put on the wait list for the above listed camp.

If a space opens up, we will contact you by e-mail and give you between 24-48 hours to complete the registration process by paying for your registration.

Fields marked with an asterisk (*) are required.

REGISTRATION INFORMATION
First name (*):

Last name (*):

E-mail (*):

Re-enter e-mail (must match above) (*):

Address line 1 (*):

Address line 2:

City (*):

State/Province (*):

Zip/Postal Code (*):

Country (*):

Home phone (###-###-####) (*):

Work phone (###-###-####):

Cell phone (###-###-####):

Emergency contact name (*):

Emergency contact number (###-###-####) (*):

Date of birth (*):
    
Age at start of camp (you must be 18 or over) (*):

Gender (*):
Male
Female
If you have checked "Male" as gender, please confirm that this is one of our co-ed camps:
Yes, this is a co-ed camp
Camp includes a sandwich based lunch each day. Would you prefer a vegetarian sandwich (*):
No
Yes
Food allergies or other allergies:
Medications, conditions, or previous injuries:
If you are a member of any cycling club or organization, which one:

How did you hear about the Dirt Series (*):

If applicable, from which specific source did you hear about us (name of web site, bike shop, club, advertisement, etc.):

Time traveling to the camp (*):

Enter any other information or special requests:

DIRT SERIES POLICIES
CANCELLATION POLICY
Over ten days before the camp date: full refund, less $50 administrative fee.
Ten to four days of the camp date: 50% refund.
Three or fewer days before the camp or "no show": no refund.
Camp registrations are non-transferable.
I understand and agree to the policies above. Type 'YES' in UPPERCASE (*):

I agree to sign a Waiver, on-line or in person, prior to the beginning of the course. Type 'YES' in UPPERCASE (*):





 
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