Team Leader Registration
Team Leader's Name
First Name
 Last Name

Team Leader's Email Address

Team Name

Work Phone Number
- -

My round-trip bicycle commute trip is miles.

I started bicycling to work (approximate)  years    months.

I get to work most of the time by:

  Bicycle    Drive Alone   Carpool
  Transit   Vanpool   Walking

Company/Division/Unit

Workplace Address

City
 Zip Code

Number of Employees in this Company/Division/Unit
(Minimum of 10 employees, maximum of 100)

Number of cyclists pledged

I hereby assume all risks inherent in any physical activity and release and hold harmless any event organizers and their employees of any and all claims and liabilities and am fit to participate in this event.

I pledge to bicycle to work at least 1 day during Bike to Work Week
May 17 - 21, 2004

  I accept   I do not accept



For more information about SABA, please contact: saba@sacbike.org
Please send corrections and revisions to: saba@sacbike.org.