Registration | Florida Bicycle Safari

Payment is via Credit Card Only (Google Checkout).

Click here for mail-in form.

Please fill out the form below. You will receive an e-mail with final confirmation.

First Name
Last Name
Check here if you DO NOT want your name / city / state listed on our website.
Address
City
State
Zip
Phone #
E-Mail
Emergency Contact
Emergency Phone

T-Shirt Size (available only if registered prior to April 1st)	S M L XL XXL

Age (if under 18 or over 80)

	3-Day Safari
Adult	$175.00 per person
FFW Club Member	$150.00 per person
Child (under 18)	$150.00 per person
Non-riding participant	$100.00 per person

	6-Day Safari
Adult	$400.00 per person
FFW Club Member	$375.00 per person
Child (under 18)	$350.00 per person
Non-riding participant	$250.00 per person
Options at Cherry Lake (additional cost). Select Only One
Dorm Room	Sold Out
Cabin	Sold Out

Other Options
Suwannee County Fairgrounds (Live Oak)
RV Site	$30 (limited space) *
RV Size (ft.)

Extra Cost Apparel 2012 Safari Jersey - $60 each
Click for sizing chart.

Jersey:	No Men's Women's
Size:	XS S M L XL XXL XXXL
Cut:	Race Cut Sport Cut (Relaxed Fit)
Not all sizes are available after March 12, 2012. You must pick up at registration. Items will not be shipped.

How did you hear about us?	Florida Freewheeler Website Past Safari Magazine (indicate below) Other Events (indicate below)
Comments

I understand that Florida Freewheelers, Inc. is not an insurer of my personal safety or liability during the Florida Bicycle Safari or any associated activities. I hereby release and forever discharge and hold harmless Florida Freewheelers, Inc., its members, agents, servants, representatives, successors, sponsors, volunteers, and assignees from all liability (personal and property) arising out of or connected in any way with my participation in this event (or my minor child’s participation in this event). I also agree to fully comply with all applicable laws and traffic regulations; to conduct my activities in a safe and prudent manner, and to wear an approved bicycle helmet and not use headphones while riding.
By checking this box you have indicated you have read the Release Form.		This will act as your signature.

Verify information is correct before hitting submit. !!! DO NOT HIT SUBMIT twice or click REFRESH !!! or you will create duplicate entries.


* Limited availability.
· No refunds will be issued after 4/1/2012 · All Children under 18 must be accompanied by an adult, at the event and particularly when riding.

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