2011 Race Team Member Application

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All applicants must complete and submit the entire form

Member Information: (PLEASE PRINT CLEARLY)


Name: _______________________________________________________________________________________

Age as of Dec 31, 2011 : _____________________________ Birth Date___________________________________

Address: ______________________________________________________________________________________

City: ______________________ Province: __________________ Postal Code: _____________________________


Phone Number: _______________________________


Cell  Number:  ________________________________                                  

                                                                                                                                                                                                                                                                                 Email Address: ________________________________


Emergency Contact Name: _____________________Emergency Phone:___________________________________


Member has a valid UCI OCA license.    Yes _______ No _______  License number__________________________


If you were a member of the Wild Bettys inaugural season, what did you like about being a Wild Betty?_________

_____________________________________________________________________________________________


Why do you want to race on the Wild Bettys Race Team?_______________________________________________

_____________________________________________________________________________________________

What type of races would you like to enter in 2011, i.e Ocup, 8 Hour, 24 Hour, etc?___________________________
 
_____________________________________________________________________________________________

How would your best friend describe you if asked to use only one word? ___________________________________

_____________________________________________________________________________________________


Racing/Riding experience, ie how many years, events you've done etc____________________________________

_____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________


What would you tell someone who asked you about the Wild Bettys?_____________________________________

____________________________________________________________________________________________

_____________________________________________________________________________________________

Application Deadline December 15, 2010. Team Roster will be announced December 31, 2010.

  • race team members must committ to purchasing a UCI race license and/or compete in 3 or more races in 2011
  • successful candidates will be sponsored by the Wild Bettys and be required to proudly wear the Wild Bettys kit provided at all events/races
  • race team members will be required to attend our Sign Up and Social on April 26, 2011
  • race team members will be required to attend at least 3  Tuesday weekly rides with the Bettys during the 2011 season 
  • Ideally race team members, and especially those new to racing, should avail of the Steve Neal Performance Wild Bettys Learn to Race Program.

 

Submit Race Team Application in one of following ways

  1. on line
  2. print and fax to (416) 929 3622
  3. by mail to Wild Bettys, 266 Douglas Drive Toronto, ON M4W2C1

Wild Bettys
266 Douglas Drive
Toronto, ON M4W2C1

All information will be kept private & confidential to the Wild Bettys.