CAMP INFORMATION

Camp name: Park City, UT
Camp date: Saturday-Sunday, July 26-27, 2014
Price: $345 USD
Camp Registration

DO NOT use the BACK button on your browser during the registration process. You will have an opportunity to review and correct information prior to final checkout.

Fields marked with an asterisk (*) are required.

REGISTRATION INFORMATION
First name (*):

Last name (*):

E-mail (*):

Re-enter e-mail (must match above) (*):

Address line 1 (*):

Address line 2:

City (*):

State/Province (*):

Zip/Postal Code (*):

Country (*):

Home phone (###-###-####) (*):

Work phone (###-###-####):

Cell phone (###-###-####):

Emergency contact name (*):

Emergency contact number (###-###-####) (*):

Date of birth (*):
    
Age at start of camp (you must be 18 or over) (*):

Gender (*):
Male
Female
If you have checked "Male" as gender, please confirm that this is one of our co-ed camps:
Yes, this is a co-ed camp
Camp includes a sandwich based lunch each day. Would you prefer a vegetarian sandwich (*):
No
Yes
Food allergies or other allergies:
Medications, conditions, or previous injuries:
If you are a member of any cycling club or organization, which one:

How did you hear about the Dirt Series (*):

If applicable, from which specific source did you hear about us (name of web site, bike shop, club, advertisement, etc.):

Time traveling to the camp (*):

Enter any other information or special requests:

DIRT SERIES CAMP SHIRTS ($55-$60 plus applicable taxes, click here for details)
Do you want to purchase a Dirt Series jersey to be picked up at camp (*):
Yes
No
Select shirt design, size, and colour:


DIRT SERIES HYDRATION PACKS ($85 plus applicable taxes, click here for details)
Do you want to purchase a Dirt Series hydration pack to be picked up at camp (*):
Yes
No
Select pack style:


DIRT SERIES DUFFLE BAGS ($40 plus applicable taxes, click here for details)
Do you want to purchase a Dirt Series duffle bag to be picked up at camp (*):
Yes
No
If you'd rather have your duffle bag (or any of your other purchases) shipped out to you so that you can use them before you get to camp (or even on your way to camp) then please email us here and we'll get in touch with you about shipping rates.

DIRT SERIES POLICIES
CANCELLATION POLICY
Over ten days before the camp date: full refund, less $50 administrative fee.
Ten to four days of the camp date: 50% refund.
Three or fewer days before the camp or "no show": no refund.
Camp registrations are non-transferable.
I understand and agree to the policies above. Type 'YES' in UPPERCASE (*):

I agree to sign a Waiver, on-line or in person, prior to the beginning of the course. Type 'YES' in UPPERCASE (*):


PROMOTION CODES AND GIFT CERTIFICATES
If you are using a gift certificate, enter your gift certificate code:

If you are an employee of one our sponsors, enter your promotional code as well as your company name and position below. If you are one of our scholarship recipients, also enter your code below and write "scholarship recipient" in the company / position field.
Promotion code:

Company/Position:


PAYMENT OPTIONS
You will have a chance to review your charges before final submission of payment. Only fill out the credit card information if you have selected Visa/Mastercard as your payment option. If you have purchased a t-shirt, hydration pack or bag, select either the credit card or PayPal option even if you are using a gift certificate or promo code, so that you're able to pay for those items.
Payment type (*):
Visa/Mastercard
PayPal
Gift Certificate or Promo
Credit card type:

Card number:

Expiration date:
 
Card verification number:

First name on credit card:

Last name of credit card:





 
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