Please enter first and last name:

Please enter the address of the primary member:

     Street City, State and Zip Code

Please enter telephone number:

Please enter your e-mail address:

What are the family's riding preferences (choose all that apply):

    <13 MPH          13 to 15 MPH        16 to 18 MPH          19+ MPH

    Racing             Touring                 Recreational           ATB (Mountain Biking)

Would you be willing to volunteer with the following (check all that apply):

     Leading a Ride         Racing Events         SAG (Provide Vehicle Support Club Rides)

     Parties                    Community Events

Do you want your name and address on the local bicycle shops mailing lists or the published membership list?

     Yes, it is okay.          No, it is NOT okay.

Would you like to receive your newsletter via e-mail instead of U.S. Mail?

     Yes                          No

When you click the REGISTER button the next page will take you to the payment page where you can pay with a major credit card to TBA's Pay Pal account.