The So Cal Cycle TT will be held on Sunday October 12, through Monday October 13.

Please fill out this form and send it with your check payable to Tad Yenawine for $100 +$40 for a passenger to :

So Cal TT/Tad Yenawine
813 East Kensington Road
LA, CA 90026

Your application and payment must be received by October 2, 2003.

Rider Name ($100)

Rider Address

Rider Telephone Cell phone Email

Notify in case of emergency:

Rider Tee shirt size (included with entry):

Is there someone on the TT that you would like to share a bed with?

Is there someone on the TT that you would like to share a room with?

Passenger Name($40)

Passenger Address

Passenger Telephone Cell phone Email

Notify in case of emergency:

Passenger Tee shirt size (included with entry):

Vehicle info: Year Manufacturer Model

Weight Engine displacement/type

Comments:

Number preference:

Tee shirt pre-order: $9 for each additional shirt: Size(s):

Is there any information in this application that you would like to be kept private from the other participants?

If you have any questions, please contact Tad Yenawine at 213 975 1144 or E mail at [email protected]