Please provide your contact and payment information below. Your contact information is required to generate an electronic tax receipt which will be sent to the email address that you provide. For more information, email venus@greenhousescholars.org.
Survey Questions
* Gender:
* Birth date (mm/dd/yyyy) Solely for record purposes and will not be disclosed to anyone.
* Please select your ride distance. You aren't tied in to this choice and can change your mind since all courses are the same price.
Employer's Name:
* Please select your t-shirt style: (Fitted or Unisex/Relaxed Fit options available)
* Please select your requested t-shirt size and style, and remember - for the fitted version, be sure to size up.
* Packet pick-up will be held from Friday, September 20th thru Monday September 23rd. Keep in mind that you'll need to fundraise your $75 by September 13th in order to pick your packet up in advance of the ride:
* Please select your food preference below. We'll have food trucks at the event; your food preference will be used for their planning purposes:
Would you like to buy extra lunch tickets? Extra Lunch Tickets are $10.00 each. Quantity:
* Want key cycling tips, inspiration and chances to win gear? Sign up for the monthly Trek Women News - trust us, you'll want to hear what they have to say.
* Emergency Contact Name:
* Emergency Contact Phone Number:
How did you hear about Venus de Miles?
What is your annual household income? This is helpful for our research and is strictly confidential. We take your privacy very seriously.
* Would you like to receive a one-month complimentary training plan for Venus de Miles from FasCat Coaching? It will be accessible via a one-month complimentary Training Peaks website. They are offering beginner, intermediate and advanced training plans are among the best in the business! After the first month, they will be offering a great Venus discount on their coaching packages, so you can take it to the next level!
* How did you hear about Venus de Miles?
If it was from a friend that is already signed up to ride, please list their name so we know who to thank.
* On September 29th, please sign me up for (check all that apply):
By continuing, you acknowledge that your credit card will be charged on a recurring basis for the duration outlined or until cancelled.