| NJ / NYC Brevet Series - 2008 Pre-Registration Form |
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| Details
of the rider: |
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| Last Name: |
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First Name: |
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DOB: |
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Gender: |
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| Address: |
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City: |
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Zip: |
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e-mail: |
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RUSA #: |
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| Home phone: |
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Cell phone: |
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| Affiliated club: |
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Type of bike: |
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| Emergency
contact: |
Name: |
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Phone: |
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| ��������� Check box if you do not wish to
have your name published on njrando.com (RUSA# will be used in its place). |
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| Calendar
of events |
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| Date |
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Start |
Venue |
Brevet |
�������� Distance |
Profile |
Volunteer |
Type of |
BMB |
Entry |
Entries |
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Organizer |
miles |
km |
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support |
Brevet |
qualifier |
fee (US $) |
�(US $) |
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| Saturday,
April 19th |
7h00am |
Princeton, NJ |
B. Mazur |
126 |
200 |
Hilly |
No |
ACP* |
Yes |
10 |
completed |
| Saturday,
May 17th |
4h00am |
Princeton, NJ |
B. Mazur |
187 |
300 |
Hilly |
Some |
ACP |
Yes |
25 |
completed |
| Saturday,
June 21st |
5h00am |
Englewood,NJ |
L. Chambard |
252 |
400 |
Fair |
Yes |
ACP* |
Yes |
30 |
completed |
| Fri/Sat/Sun,
July 11,12,13 |
22h00pm |
Cranbury, NJ |
L. Chambard |
374 |
600 |
Flat |
Yes |
ACP |
Yes |
60 |
completed |
| Sunday,
August 10th |
4h00am |
Manhattan, NY |
OPEN |
187 |
300 |
Hilly |
Some |
ACP |
No |
15 |
completed |
| Sunday,
September 14th |
7h00am |
Manhattan, NY |
OPEN |
126 |
200 |
Hilly |
No |
ACP |
No |
10 |
completed |
| Sunday,
October 12th |
7h00am |
Manhattan, NY |
OPEN |
117 |
188 |
Hilly |
No |
RUSA |
No |
10 |
completed |
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*Pending RUSA approval |
** There is a $5
surcharge for same day registration |
Late Fee: |
5** |
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Working lights are
mandatory on ALL events except the NYC Populaire on October 12th |
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Total entry fees: |
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| Please
mail this completed form
together with your entry fees, checks payable to Leroy Varga, at: |
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Signature: |
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| Leroy
Varga, 27 Beaufort Avenue, Dover NJ 07801
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Date: |
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| To qualify
for pre-registration, entries must be postmarked at least 5 days before the
event. |
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| Entries
posted after the deadline are subject to a $5 late fee at the start. �
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