Mileage Submission Form

SUBMIT for EACH 1,000 miles AT TIME of Completion
(Example: Please don’t wait until 5,000 miles to Submit)

NAME

First Name

Last Name

CITY / STATE

Email Address

Mileage Level Selection (Select Below)

E-BIKE Mileage Included? ⚡

IF ANY OF YOUR TOTAL MILES ARE E-BIKE PLEASE CHECK "YES"

YES

CURRENT MILEAGE

Proof of Miles (Select Below)

FACEBOOK Name (if different from above)

STRAVA Name (if different from above)

OPTIONAL: Strava / GPS Info (Athlete ID / Paste URL) / Comments