Bikepacking Roots · Cabezon Campout Registration Form

Please submit one form per participant.

Name

*

First Name

Last Name

Email

*

Verify Email

*

Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Age

What are your preferred pronouns?

He/Him

She/Her

They/Theirs

Something Else

How much bikepacking experience do you have?

*

This will be my first time bikepacking!

I've been out at least a few times

I've got quite a bit of experience

What are your goals for the campout? ( Check all that apply.))

*

To have fun.

To build community.

To ride somewhere new.

To gain bikepacking experience.

Other.

How do you plan to ride?

*

Unloaded (All your gear in the SAG vehicle.)

Partially Loaded (Some of your gear in the SAG vehicle.)

Self-Supported (All of your gear on your bike.)

Do you have any medical conditions or history that we should know about?

Emergency Contact Name

Emergency Contact Phone Number

Emergency Contact Relationship

Is there anything else we should know?

Participant Agreement

*

I am at least 18 years of age, or will be participating with a parent or guardian.

I am willing to sign a liability waiver at start of the event.

Liability Waiver

Please Sign the Waiver Here

This event is absolutely free and open to all. If you can spare a few bucks to help Bikepacking Rotos cover insurance, permitting and staff travel costs, it would would be a huge help. If not, no worries!

Optional Donation Amount

$

If you aren't already a member of Bikepacking Roots, registering for this event includes a free lifetime membership. We'll send you occassional updates about our work. We won't share your information with anyone else.