Geneva College

 

 

Cycle To The Sea - Application

Complete the form below to sign up for the Geneva Across America:
Cycle To The Sea July 10 - 17 2013. Application deadline - May 31

Personal Information
Name *
Email *
Gender
Male
Female
Cell Phone
Office Phone
Classification
Student
Staff
Faculty
Alumni
Friend
T-Shirt Size
Rate your bike skill level:
Insurance Information
Relevant Medical Information
(Food allergies, heart conditions, etc)
Insurance Company
Insurance Card #
Emergency Contact
Signature
By typing my name in the box below, I freely accept all the risk associated with this trip and do hereby release Geneva College and all its employees from any and all liability associated with this activity. In additional, I agree to fully participate as a member of the community and giving my all to this epic adventure.
Signature

 

Point of Excellence

Geneva College is one of only 15 CCCU schools in the nation that offers an ABET-accredited, four-year engineering program.

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