NJ / NYC Brevet Series - 2008 Pre-Registration Form
Details of the rider:                      
Last Name:     First Name:     DOB:     Gender:    
Address:                 City:    
State:   Zip:   e-mail:       RUSA #:    
Home phone:       Cell phone:        
Affiliated club:       Type of bike:        
Emergency contact: Name:         Phone:      
          Check box if you do not wish to have your name published on njrando.com (RUSA# will be used in its place).
Calendar of events                      
Date Start Venue Brevet          Distance Profile Volunteer Type of BMB Entry Entries
  Organizer miles km support Brevet qualifier fee (US $)  (US $)
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
  *Pending RUSA approval ** There is a $5 surcharge for same day registration Late Fee: 5**  
  Working lights are mandatory on ALL events except the NYC Populaire on October 12th   Total entry fees:  
Please mail this completed form together with your entry fees, checks payable to Leroy Varga, at: Signature:    
Leroy Varga, 27 Beaufort Avenue, Dover NJ 07801 Date:    
To qualify for pre-registration, entries must be postmarked at least 5 days before the event.
Entries posted after the deadline are subject to a $5 late fee at the start.