PERIMETER RIDE REGISTRATION

PERIMETER BICYCLING RECORD FORM


Name:

Home phone:

Address: Work phone: City: State: Zip: PBAA Member:

In order for your bicycling trip to be declared a perimeter accomplishment and/or recorded in the PBAA Accomplishment records, the following questions must be answered: (PLEASE USE INK OR TYPE ALL ANSWERS)

(1) What is the "perimeter' trip that you want PBAA to record?

(2) What type of perimeter is this? Town City County
state

Lake Mountain Range Island Other: (please specify)

(3) If you already bicycled this perimeter, fill in the following information:

(a) Date of perimeter trip:_____________ (b) Start 8 Finish Location:_____________

(c) Starting time: Date:+_______________ (d) Finishing time: Date:_____________

(e) Total time:_______ Days:______ Hours:______ Minutes:_______

(f) Total distance (in miles):___________

(g) Is this ride part of an organized event?( ) Yes ( )No

(h) Did you bicycle the entire distance?( )Yes ( )No

(i ) Did PBAA approve this route before you set out on your perimeter trip? ( )Yes ( )No

( j ) Did you bicycle the entire planned route given to you by PBAA? ( )Yes ( )No

(k) To the best of your knowledge. has anyone ever bicycled this perimeter before?( )Yes ( )No



Seconds:

Please check whichever applies:
[ ] Solo - I rode alone

[ ] Accompanied - I rode with one or more cyclists

[ ] Event - I rode in a perimeter event

[ ]Support- I had crew support

If you answered "No" to questions 3h or 3j, please explain on the reverse side (type please).

Print this form fill it out, and send, with a copy of your map to:

PBAA ATTN. Membership Director 630 N. Craycroft. Suite#127 Tucson. AZ 85716

Please allow one month from mailing date for accomplishment confirmation.

Thank You