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2. First Name*
3. Last Name*
5. Email*
6. Bicycle Needs*

   Bike size, adult or child, age of child (N/A if you will use your own bike)

8. I understand and accept that I must wear a helmet throughout the duration of the Slow Roll bike ride. *

   1. I accept
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10. 1. Receive an email copy of this form.
11. Email address

    This field is not part of the form submission.

12. Submit

* indicates a required field