Gainesville Cycling Club 2008 Brevet Series Registration Form

    (X)     Event     Distance      Cost
    ( )     Jan 12    200 km        $20 ($15 GCC members)
    ( )     Feb 9     300 km        $25 ($20 GCC members)
    ( )     Mar 8     400 km        $30 ($25 GCC members)
    ( )     Apr 5     600 km        $40 ($35 GCC members)

(Gainesville Cycling Club members receive a $5 discount per event.  The
annual GCC membership fee is $15.)

    ( )     To join GCC, visit http://gccfla.org/join.html to fill out
            and print an application.  Enclose the application with
            this registration form, and add $15 to your payment.

Amount enclosed __________.
Make checks payable to "Gainesville Cycling Club"

Name:_____________________________________________________________

Address:__________________________________________________________

City:______________________________ State:________ Zip:___________

Email:________________________________________  RUSA#:____________

Emergency Contact:________________________________________________

Emergency Phone:__________________________________________________

Complete and send to: Jim Wilson
                      620 NW 27 Way
                      Gainesville, FL 32607