First Name:   
Last Name:    
Street:           
Second Line:  
City:              
State:                 Zip Code

Email address: (This should be the address where you would like to receive team mailings as well as the Wenzel Coaching newsletter)

Daytime Telephone Number:  (For optional Team Directory and any questions about your sign up.)
Mobile Telephone Number (optional):   

Sex: M   F

Age: (Team members may be any age. Applicants under age 18 must have a guardian sign the release)

Your Wenzel Coach (if applicable):

Riding/Racing focus: (Road, MTB, Cyclocross, Track, Century, Touring, Ultra Endurance, etc)

 
Please contact me about ordering additional clothing items such as skinsuits, jackets, vests, arm/leg warmers, caps or other items.
Please do not list me as a member of the team on the Wenzel Coaching website.