31 July to 21 Aug 2011

EXTREMELY IMPORTANT

NO ONE will be refused to ride due to lack of funds.  AIDS Ride South Africa very much appreciates the philosophy of sliding scale.  In cases of individual economic difficulty we encourage everyone interested to register regardless of financial resources, and will work with participants to help you fundraise, obtain proper equipment, helmets, gear, micro-finance and so on so that you can cycle with us.  This dream is SO huge it will only work if we work to get there TOGETHER!

Cycle on,

Bryan Mark Urbsaitis, PhD
AIDS Ride South Africa Founder, Cyclist, Director

• DONATE
• REGISTER
• VOLUNTEER
• MARKET

CYCLIST REGISTRATION FORM
All blanks marked by * are required.
First Name: *	Last Name: *
Postal Address: *
City: *	Zip/Post Code: *
State or Province: *	Country: *
Email: *
Mobile Phone (Country Code/Area Code): *
Indicate your cycling ability: * NOVICE ADVANCED PROFESSIONAL
How much of the route will you be riding? * ENTIRE ROUTE: Johannesburg to Cape Town LEG 1: Johannesburg to Bloomfontein LEG 2: Bloomfontein to Beaufort West LEG 3: Beaufort West to Cape Town
* I commit to the fund-raising efforts of AIDS Ride South Africa, Ltd., and agree to raise a minimum of: $200 USD (1000R) for South African resident Cyclists $500 USD (3000R) for Non-SA Cyclists This amount is to be contributed before the start of the event.

Please complete your registration by paying the $75 USD NON-REFUNDABLE REGISTRATION FEE through PayPal:

ARSA 2011 Cyclist Registration Fee = $75.00 USD
Cyclist Name: