Name *
Your Cell Phone *
Emergency Contact *
Contact Cell Phone *
Gender *MaleFemale
Benz Riding Kit: Please select one size for the top (jersey) and bottom (short).
Jersey *SMLXLXXLXXXL
Short *SMLXLXXLXXXL
Bike Size
Your Height *
Inside Leg Length *
I will bring my own bike? *YesNo
Pedals & Clips
I will be riding: *Clipped InNot Clipped In
What type of pedal will you need?
Look Keo, Shimano SPD, Speedplay, Shimano SPD SL