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Parkinson’s Revolution Registration Form
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Please complete the information below to register for the February 8th Parkinson's Revolution Ride at HealthFit.
RM_Stats
First Name
*
Last Name
*
Your Address
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Address Line 2
City
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State or Region
AL
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State or Region
*
Zip
*
Email
*
Select your ride!
45 Minute Ride for $20
90 Minute Ride for $30
Parkinson's Disease Connection
*
Select an option
I have PD
Family Member has PD
Friend has PD
I Work with the PD community
Your Message
*
Thank You!
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