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February 9, 2012

Athlete’s Request Form

Please fill out the information below for your team page. Please note, if your are 13yrs or under, please have your parents fill out the information provided below and fill out the COPPA agreement and return to PPC Racing BMX.

Your Name (required):

Your Email (required):

Your Nickname:

Your Sport:

Your City:

Your State:

Your Class (Novice, Intermediate, Expert):

Your Age:

Age When First Started Competing:

Your Favorite Tracks:

Your Favorite Tricks:

Sponsors:

Career Honors, Awards and Highlights:

Additional Bio Info:

File Upload - Please send you pictures or files:

(*Zip format is preferred. Limit 5meg, Formats:gif, jpg, png, flv, pdf, doc, zip, rar, sit):

* YES, I agree to the Terms of PPC Racing BMX's Privacy Policy and Terms of Use

*Children Under 13

Parents Name:

Parents Phone:

Parents Email:

** Parents, the information provide about your children's age, racing class, photos and team activities will be posted on the web site and social feeds. Click Here to download and save COPPA - Parental Consent Form for children under 13, this must be signed and returned to Adria Scott at PPC Racing BMX.

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