Registration

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=90 BGCOLOR="#CCFF99" TEXT="#080000" bgproperties="fixed" background="12a78671esnimw.png"> <div> <FONT SIZE="5" COLOR="#CCFF99" FACE="Arial" ><B>Brushy Mountain Cyclists Club</B></FONT><FONT SIZE="2" COLOR="#333399" FACE="Times New Roman" ><B>     |  </B></FONT><A HREF="rrr.htm" TARGET="_top" TITLE="Rollin Round the River Ride"><U>Rollin' Round the River </U></A><A HREF="rrr.htm" TARGET="_top" TITLE="Rollin Round the River Ride"><U>Ride main page</U></A> |   <A HREF="index.htm" TARGET="_top" TITLE="Brushy Mountain Cyclists Club"><U>BMCC</U></A><A HREF="index.htm" TARGET="_top" TITLE="Brushy Mountain Cyclists Club"><U> </U></A><A HREF="index.htm" TARGET="_top" TITLE="Brushy Mountain Cyclists Club"><U>home</U></A> |  <B>Registration</B>   |   <A HREF="id22.htm" TARGET="_top" TITLE="Information"><U>Information</U></A>   |   <A HREF="id28.htm" TARGET="_top" TITLE="Directions"><U>Directions</U></A>   |   <A HREF="id24.htm" TARGET="_top" TITLE="Links"><U>Links</U></A>   |   <A HREF="id29.htm" TARGET="_top" TITLE="2002 RRRR"><U>2002 RRRR</U></A>   |   <A HREF="id32.htm" TARGET="_top" TITLE="2003 RRRR"><U>2003 RRRR</U></A>   |   <A HREF="id39.htm" TARGET="_top" TITLE="Chris Clarida...our gold medalist"><U>Chris Clarida...our gold medalist</U></A>   |   <A HREF="id52.htm" TARGET="_top" TITLE="2004 RRRR"><U>2004 RRRR</U></A>   |   <A HREF="id59.htm" TARGET="_top" TITLE="2005 RRRR"><U>2005 RRRR</U></A>   |   <A HREF="id88.htm" TARGET="_top" TITLE="2006 RRRR"><U>2006 RRRR</U></A>   |   <A HREF="id92.htm" TARGET="_top" TITLE="2007 RRRR"><U>2007 RRRR</U></A><FONT SIZE="3" COLOR="#333399" FACE="Arial Narrow" > </FONT></div> <div> </div> </td> </tr><tr> <td valign="top" width=200 BGCOLOR="#336699" TEXT="#080000" bgproperties="fixed" background="12bc83b3.png"> <div> <B><IMG SRC="210a87e0.jpg" border=0 width="168" height="126" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></div> <bR> <bR> <bR> </td> <td valign="top" height=390 BGCOLOR="#CCFF99" TEXT="#080000"> <div> <I><B>Registration</B></I></div> <bR> <DIV ALIGN="LEFT"></DIV> <div> <I><B>Registration forms for the Rollin' Round the River Ride will be available in summer 2008 at Cooks in North Wilkesboro and other area bike shops.</B></I></div> <bR> <div> <I><B> <a href="HTMLobj-2613/2007 RRRR app and info sheet.pdf"><u>Click here to download a registration form and info sheet (PDF).</u> </a>  </B></I></div> <bR> <div> <I><B>Complete the form below and we'll mail you a Rollin' Round the River registration form.</B></I></div> <bR> <div> <I><B> <form action="http://formmail.trellix.com/servlets/TlxMailer" method="POST" enctype="application/x-www-form-urlencoded"><input type="hidden" name="tlx_SortOrder" value="FirstName,LastName,Email,Address1,Address2,City,State,Zip,Phone,MailingList"><input type="hidden" name="tlx_FormIndex" value="2"><input type="hidden" name="tlx_OKMessage" value="Registration materials will be sent to you via U.S. mail."><input type="hidden" name="tlx_SendMode" value="1"><input type="hidden" name="tlx_Subject" value="Rollin' on the River reg. request"><input type="hidden" name="tlx_EmailTo" value="brushymtncc@aol.com"> <table cellpadding="0" cellspacing="1" border="0" align="center"> <tr> <td align="left">First Name:<br> <input type="text" name="FirstName" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Last Name:<br> <input type="text" name="LastName" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Email:<br> <input type="text" name="Email" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Address Line 1:<br> <input type="text" name="Address1" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Address Line 2:<br> <input type="text" name="Address2" size="30" maxlength="100"></td> </tr> <tr> <td align="left">City:<br> <input type="text" name="City" size="30" maxlength="100"></td> </tr> <tr> <td align="left">State:<br> <input type="text" name="State" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Zip:<br> <input type="text" name="Zip" size="10" maxlength="10"></td> </tr> <tr> <td align="left">Phone Number:<br> <input type="text" name="Phone" size="14" maxlength="14"></td> </tr> <tr> <td> <input type="checkbox" name="MailingList" value="yes"> Add me to BMCC's e-mail list</td> </tr> <tr> <td align="right"><input type="reset"> <input type="submit" value="Send" name="tlx_send"></td> </tr> </table> </form>  </B></I></div> <bR> <bR> <bR> </td> </tr></table></body>