UMCA Mileage Challenge
UMC Century and Standard Divisions
Multi-Ride Event Form
For PAC Tour, Hell Week, etc.
| Rider Name _________________________ | Address _______________________ |
| City _______________________________ | State ______ Zip ________________ |
| Phone _____________________________ | Email _________________________ |
| Name of Event | Dates of Event | |||||
|---|---|---|---|---|---|---|
| Ride Date |
Name/Description of Ride/Stage | Miles Published |
Miles Ridden |
Division* (C/S) |
Official's Initials |
|
| Event Official's Name _________________________ | |
|---|---|
| Official's Signature _________________________ | Date ____________ |
Event Official: Please sign above to validate this cyclist's ride. Thank you!
Rider: (1) Have an event offical who can validate your ride sign this form.
(2) Send this form with event documentation to
John Lee Ellis, 2155 Dogwood Circle, Louisville, CO 80027.
Event Documentation can be an event flyer or announcement for the ride,
including mileage, or map, or cue sheet for the ride.