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BMX Racing Registration Form
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Categories
*
Male Rider
Female Rider
Event Information
Which events are you riding in?
*
BMX
Cruiser
Which events are you riding in?
*
BMX
Cruiser
Please select your experience level
*
Novice
Intermediate
Expert
BMX Division
*
-- select one --
5 Years & Under
6 Years
7 Years
8 Years
9 Years
10 Years
11 Years
12 Years
13 Years
14 Years
15 Years
16 Years
17-20 Years
21-25 Years
26 Years & Over
BMX Division
*
-- select one --
5 Years & Under
6 Years
7 Years
8 Years
9 Years
10 Years
11 Years
12 Years
13 Years
14 Years
15-16 Years
17-20 Years
21 Years & Over
Cruiser Division
*
-- select one --
9 Years & Under
10 Years
11 Years
12 Years
13 Years
14 Years
15 Years
16 Years
17-20 Years
21-25 Years
26-30 Years
31-35 Years
36-40 Years
41-45 Years
46-50 Years
51 Years & Over
Cruiser Division
*
-- select one --
10 Years & Under
11-13 Years
14-16 Years
17-20 Years
21-25 Years
26-30 Years
31-35 Years
36-40 Years
41 Years & Over
Participant Information
Contact Email
*
Participant First Name
*
Participant Last Name
*
Participant Birthdate
*
- month -
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
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- day -
1
2
3
4
5
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8
9
10
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12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
- year -
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
Participant Gender
*
Male
Female
Country
*
-- select country --
Canada
International
United States
Street Address (w/Apt#)
*
City
*
State
*
-- select state --
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Col.
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
-- select state --
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Col.
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
-- select province --
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Zip Code
*
Phone
*
Would you like to
receive important event text alerts
on this number (eg. changes or delays)?
Emergency Contact Name
*
Emergency Phone
*
Athlete Shirt
Product Sizing
Product Sizing
Product Sizing
Would you like a shirt?
*
Yes
No
NOTE: The FREE shirt ONLY applies to the White Cotton. You may purchase multiple for each type of shirt.
Upgrade shirt color is subject to change.
FIRST ONE FREE, $12 FOR EACH ADDITIONAL
White Cotton
click to enlarge
Click Here for product details and/or sizing
Show Product Options
Youth S
Youth M
Youth L
Adult S
Adult M
Adult L
Adult XL
Adult 2XL
Adult 3XL
Adult 4XL
UPGRADE OPTION, $18 per Shirt
Soft-T Short Sleeve
$18
click to enlarge
Click Here for product details and/or sizing
Show Product Options
Youth S
Youth M
Youth L
Adult S
Adult M
Adult L
Adult XL
Adult 2XL
Adult 3XL
Adult 4XL
UPGRADE OPTION, $25 per Shirt
Soft-T Long Sleeve
$25
click to enlarge
Click Here for product details and/or sizing
Show Product Options
Youth S
Youth M
Youth L
Adult S
Adult M
Adult L
Adult XL
Adult 2XL
Adult 3XL
Adult 4XL
Shirt Shipping Address
*
Is this the same as the address entered above?
*
Yes
No
Country
*
-- select country --
United States
Street Address
*
City
*
State
*
-- select state --
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Col.
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
-- select state --
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Col.
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
-- select province --
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Zip Code
*
Make a Donation
Nebraska Sports Council - Adopt an Athlete
Amount $
Waiver
*
I have read and agreed to the TERMS
*
Click here to view the TERMS
.
Is the participant 18 or older?
*
18 or older
Under 18
Parent or Legal Guardian’s Signature - By providing your electronic signature you agree that you have the authority to register these participants and agree to the waiver(s) for them as their parent or legal guardian.
If registering a child under 18, you are consenting to the collection of the child's information that you are providing for the purposes of registration.
Parent's signature
Payment Details
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Discount (-)
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Donation
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Total Owed
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