Registration | AIDS Ride for Life

Rider Registration

9/11/2021

The AIDS Ride for Life will be held on September, 11th. Registration opens April 1st 2021 on our fundraising plaform. Please visit our Salsa fundraising platform to register for the event

About you
First Name
Last Name
Email
Date of Birth
* You cannot register online because you will be under 14 years old on the day of the ride. Please email crotella@stapinc.org if you have any questions.
Gender MFT
Existing Medical Conditions? YesNo
List of Conditions
Contact Info
Phone Number
Street
Apt / Suite
City
State
ZIP Code
Accompanying Adult Rider
Full Name
Date of Birth
Email
Phone Number
Emergency Contact
* Your emergency contact cannot be another rider.
Full Name
Relationship
Phone Number
About the Event
Miles you will ride 1425426990102Indoor
Are you in a team? YesNo
Team Name
Are you the team captain? YesNo
Accept T-Shirt and gifts? YesNo
T-Shirt Size
Are you a first time rider in the Ride? YesNo
How many times have you ridden prior?
Will you be attending 6pm dinner at Stewart Park? YesNo
* You and one guest are included in your registration fee. Additional guests are $8.00 each (pay at dinner).
Total number of dinner guests including yourself
Other
How did you hear about the ride?
Training Notify me of about training rides.
ARFL Sign I would like to display an ARFL sign for my yard.
Sponsorships I would like to learn more about Sponsorship Opportunities.
Other Events I would like to receive information about other STAP events.
Registration Fee & Fundraising
Fundraising In addition to the registration fee, I understand there is a minimum $300 fundraising requirement. In addition to the registration fee, I understand there is a minimum $100 fundraising requirement. 100 In addition to the registration fee, I understand there is a minimum $100 fundraising requirement. 100
Registration Fee $ 25 25 25
Discount Code YesNo
Waiver I have read and agreed to the rider waiver.
You had errors on your form. Please fix them and re-submit. A confirmation e-mail will be sent to you after you have paid the registration fee.

Registration Fee

We use PayPal to accept payments. You will receive a confirmation email once the PayPal payment is confirmed.

Rider Registration

About you

Contact Info

Accompanying Adult Rider

Emergency Contact

About the Event

Other

Registration Fee & Fundraising

Registration Fee