KBB Alumni Participation Form

Student Info

Student Name(Required)
Student Address(Required)
Birthday(Required)
Does your child plan on bringing the bicycle they earned from the program for the ride?(Required)

Parent/Family Info

Parent/Guardian Name(Required)
Parent/Guardian Address (if different than child's)
Will you or another parent/guardian be joining on the ride?(Required)
Do you own a bicycle that you can bring to use on the ride, or would you need to borrow one from us?(Required)

Emergency Contact Information

Name:(Required)
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