n at ion a l Bik e summ it 2 010 M a rch 9 -11, 2010 • Wa shington, D.C.
Pr e s e n t e d by:
Register online at www.bikeleague.org.
Sp o ns or e d by:
R egist r at ion Fees
First 100 League Members to Register Online at www.bikeleague.org by 12/31/2009: $285
To celebrate the 10-year Summit anniversary, the first 100 League members to register online at www.bikeleague.org will receive a discounted registration rate of $285 – the registration fee for the Summit 10 years ago! Offer ends December 31, 2009.
R egist r at ion I nfor m at ion
Early Bird*
Regular
League Member:
$375
$475
Non-member: One-day: Bike Rental:
$455 $245 $35
$580 $370 $35
(Congressional Bike Ride)
Total: $
$
*Early Bird: Postmarked or registered online before 2/4/10. $50 administrative fee for cancellations prior to 2/18/10. No refunds after 2/18/10.
Name:
Mailed registration must be postmarked by 3/2/10 and online by 3/4/10. Address:
m e m ber ship
Company:
Yes! I want to join the League of American Bicyclists and attend the Summit at the member rate.
Position :
Membership Level: E-mail: League Membership #: Phone: Fax: Congressional District:
I plan on attending the advocacy training on Tuesday, March 9 I am unable to participate in Congressional meetings I would like to rent a bike for the Congressional Bike Ride
Please select from the following: Advocate Government Industry: Supplier Industry: Dealer Other
$35 $50 $60 $85 $110
$65 $95 $115 $165 $215
Life Member: $1,000 Life Membership $1,500 Life Family Membership Total: $
r egistr ation M arch 9 - 11, 2010
$
Paym en t I nfor m at ion
Check enclosed (payable to the League of American Bicyclists)
Please charge my:
Visa
MasterCard
Card #
AmEx
Exp. Date
Building on
10 Years
of Progr ess
Card Holder’s Name Billing Address
None Vegetarian Vegan Other Bike Rental (for Friday’s Congressional Bike Ride): L
Check if same as above address.
Address
City
M
2 Year
Signature
Special dietary needs:
Bike Size: S
Individual Member: Family: Advocate: Advocate Family: Silver Spoke:
1 Year
Nationa l bik e summit 2010
State
Fax to: 202-822-1334, Mail to: League of American Bicyclists 1612 K Street NW Suite 800, Washington, DC 20006
Zip
Pr e s e n v t e d by:
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