Register for Tour

Upon completing this form your credit card information will be sent via our secure site. MasterCard, Visa and American Express accepted for tour deposits only.

Tour:
First Name:
Last Name:
Street:
City:
State/Province:
Zip Code: (Postal Code)
Country:
Home Phone:
Mobile Phone:
Email:
Occupation:
If retired, please indicate former occupation.
Retired? Yes No
Date of Birth: MM/DD/YYYY
Gender: Male Female
Jersey Size:
Accommodations:
How did you find us?
Did you speak to a CrossRoads' alumni before registering? Yes No
If yes please specify:
How many miles do you ride each year?
Will you be raising money for a charity? Yes No
If yes, which charity?
Comments:
Credit Card Information
Name on Card:
Card Number:
Expiration Date:
CCV:
Amount: $300.00 Deposit (Applied to tour fee)
Agreement
Upon receipt of this form and credit card deposit, CrossRoads will reserve a place on the above mentioned tour (based on availability). I agree to abide by all stated obligations and rules associated with any tour for which I register. I have read and understand the CrossRoads' cancellation policy posted on the Details page.
I agree
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