Team Name:
Team Captain:
Team Phone*:
* Cell phone that will be in team vehicle
Race Category: Mens Womens Coed
Name:
Address:
City:
State:
Zip:
Phone:
Email:
Gender: Male Female
Birthdate:
Buy a Jersey? Yes - Mens, $50.00 Yes - Womens, $50.00 No Thanks Jersey Images
Jersey Size: XS S M L XL XXL 2012 Jersey Sizing
Buy Bibs? Yes - Mens Bibs, $70.00 Yes - Womens Shorts, $70.00 No Thanks
Bibs Size: XS S M L XL XXL 2012 Jersey Sizing
T-Shirt Size: XS S M L XL XXL *T-Shirt is Free!
How many Mens Rockwell Relay watches would you like to purchase?
0 1 2 3 4 X $200.00 each Quick view of Mens Watch
How many Womens Rockwell Relay watches would you like to purchase?
0 1 2 3 4 X $100.00 each Quick view of Womens Watch
How many Teamgive watches would you like to purchase?
0 1 2 3 4 X $250.00 each Quick view of Teamgive Watch
How did you hear about the Rockwell Relay?
Web search / browsing Friend Bike shop poster Cycling calandar of events At other cycling event Facebook Previous Rockwell Relay Participant Other
Did someone refer you to the Rockwell Relay?
Comments / Special Instructions?
Things an announcer may say about your team.
All team members have read and agree to the Waiver and Release of Liability.
Please Note: You will pay online through Google Checkout on the next page.
Before continuing, make sure all fields are filled out and your Team Total is accurate.
