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Earn-a-Bike Form

One of MMCC's partners, the Bicycle Coalition of Maine has a great program called Earn-a-Bike. Participants learn the basics of bike maintenance and safety, and then take home a refurbished bike and a new helmet. If you or a child in your family would like to join an upcoming session, please fill out this form and we’ll get back to you.

Name of the person interested in participating

Height (in feet and inches or centimeters)

Gender

Gender
A
B
C

Language preference

Language preference
A
B
C
D
E

Day of the week preference

Day of the week preference

Time preference

Time preference

Is the participant a minor?

Is the participant a minor?
A
B

Contact phone number

Contact email (optional)