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Cycling Classes

Date:
Session 1 - Mondays June 22, 29, July 6, 13; 6 - 8 p.m.
Session 2 - Tuesdays June 23, 30, July 7, 14; 9 - 11 a.m.
Session 3 - Mondays July 20, 27, Aug 3, 10; 6 - 8 p.m.
Session 4 - Tuesdays July 21, 28, Aug 4, 11;9 - 11 a.m.

Location: Swope Park, Kansas City, MO

Description: Includes instruction and use of equipment. Open to ages 6-18, all disabilities welcome - beginner and advanced beginner riders.

Cost: $30 (NSCD-KC members), $40 (non-members)

Session: * required
Participant First Name: *
Participant Last Name: *
Parent/Guardian Name: *
Address: *
City: *
State: *
Zip Code: *
Phone: *
Email Address: *
Age: *
Date of Birth: *
Sex: Male
Female *

Payment by credit card or check made out to NSCD.

*Please charge my Credit Card:
*Card #
*Expiration Date:
Month: Year:
*Name as it appears on card:
Emergency Contact: *
Emergency Contact Phone: *
 

If paying by check, please make check payable to NSCD and mail to:Please mail registration to:
NSCD-KC
1801 Bryant St., #1500
Denver, CO 80204

Photo Release
I grant permission for Participant's picture to be used in publicity or brochures related to this event.
Agree: Yes
No *
Participant Name: *
Parent/Guardian Signature: *
Date: *
By checking this box, this will act as your digital signature. I agree
Please print this page out and bring it to the lesson with you.


P.O. Box 1290, Winter Park, Colorado 80482 USA ph: 970.726.1540 or 303.316.1540 fx: 970.726.4112
Denver Office: 1801 Bryant St, Ste 1500, Denver, CO 80204 ph: 303.293.5711 fx: 303.293.5448 Email:
info@nscd.org
KC Office: 4600 E. 63rd St, Kansas City, MO 64130 ph: 816.513.7571 Email:
infokc@nscd.org

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