Rider Application

Name*
First Last
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Post Title
Position*
Company*
Quote*
Email*
Cell Phone*
Emergency Contact Name*
Emergency Contact Number*
Website
Please include https:// or http://
Twitter Handle
LinkedIn URL
Please include https:// or http://
Rider Picture*
Accepted file types: jpg, jpeg, png, gif.
Locations to Attend*
- Essex Junction
- Hyde Park
- Lowell
- Bennington
- Rutland
- Brattleboro
- St. Johnsbury
- Barre
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Locations to Attend
T-Shirt Size*
tshirts are labeled in men's sizes. please choose accordingly
To complete this form, you must agree to the following terms*
- 2) I am a qualified investor or successful business owner or business advisor with a valid operating license, motorcycle endorsement, and access to a legally registered and inspected motorcycle or I will be riding as a passenger with a licensed rider and a legally registered and inspected motorcycle. I will ride safely and obey the traffic laws and rules of the State of Vermont during the Road Pitch ride.
Phone
This field is for validation purposes and should be left unchanged.