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MRTCentury Donation Form 2022
Contact Information
Name
*
First Name
Last Name
Email
*
Verify Email
*
Address
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Donation Information
Choose your Team MRTC cyclist and donate before the event. We will let you know the mileage they achieved after the event. You can donate based on mileage or choose your donation amount.
Team MRTC Members
*
Pick your favorite cyclist to direct your donation.
select one
Christiaan Abildso
Adam Baus
Stephen Cain
Colin Dierman
Marc Glass
Nathan Harlan
Gabe Holtzer
Kemp Holtzer
Charlie Shobe
John Twist
Kristina Vrouwenvelder
Amount
*
$105
-
$1 per mile
$78.75
-
75 cents per mile
$52.50
-
50 cents per mile
$26.25
-
25 cents per mile
$
Add 3% to my total amount to help cover the payment processing fees
