Use this form to register online for the 2012 Trans NH Bike Ride: Specify which ride you'd like to do:

  • 3-day Challenge, June 22, 23 & 24 (fund-raising minimum $750)
  • 2-day Ride, June 23 & 24 (fund-raising minimum $500)
  • 1-day, Celebration Sunday, June 24 (fund-raising minimum $250)
  • Support
  • Massage
Rider Information: * - DENOTES REQUIRED FIELD
* Name
   Nickname
* Address
  Address 2
* City
* State
* Zip
  Country
* Daytime Phone
* Evening Phone
* Email
* Gender
* Birthdate
* Roommate
  Note that all rooms are doubles, no single rooms.
* Shirt Size
* Vegetarian (Y/N)
* Emergency Contact
   Relationship
* Emergency Phone
* Firefighter (Y/N)
Billing Information:  your credit card will be charged $50 reg fee
* Credit card type
* Card Number
* Expires  (MM/YY)
* Security Code
* Cardholder Name

Riders wishing to cancel must notify the ride no later than June 15 to avoide being charged the fundraising minimum of $250.