Ride Leader Incentives Form

2011 CIBA Ride Leader Incentive Application

(December 1, 2010 through October 31, 2011)

Due by November 12, 2011

Name:______________________________________          Phone:_____________________________

Address:______________________________________________________E-Mail:_____________________

Name of Ride & Date: ___________________________________________Type of Ride:  _______________

For details on the award program or pictures of the items, please look on the website under CIBA / Awards

Choose one from the following if you lead the following types of rides:

1. One Traditional week end ride marked and sagged. **See note below
2. Marked training ride, dinner ride or breakfast ride
3. Total of Three unmarked rides – Grand Touring rides, dinner or breakfast rides, or any unmarked ride

Men’s long sleeve Augusta Sportswear tri-color heavyweight brushed tricot sports jacket with CIBA logo:

(circle color and size choice)

Black/Gold/White:                                           S          M         L          XL       2XL     3XL

Navy/Silver Grey/White:                                  S          M         L          XL       2XL     3XL

Red/Black/White:                                             S          M         L          XL       2XL     3XL

Women’s long sleeve Augusta Sportswear tri-color heavyweight brushed tricot sports jacket with CIBA logo:

(circle color and size choice )

Black/Gold/White:                                           S          M         L          XL       2XL

Navy/Silver Grey/White:                                  S          M         L          XL       2XL

Red/Black/White:                                             S          M         L          XL       2XL

Unisex Dunbrooke Relay Jacket – wind and water resistant polyester shell with CIBA logo:

(circle color and size choice)

Navy:                                                               S          M         L          XL      2XL     3XL

Red:                                                                S          M         L          XL      2XL     3XL

Royal:                                                             S          M         L          XL      2XL     3XL

Yellow helmet cover embroidered with CIBA logo

Blackburn MARS 3.0 Rear Light

Choose one item from the following if you lead one of these types of rides: Unmarked Grand Touring rides, dinner or breakfast rides or any other unmarked ride.  (Note:  If you lead two unmarked rides you will qualify for two of these items.  See above for three or more unmarked rides.)

Park Tool Folding Hex Set Bike Tool          Arm warmers                      Folding Duffle Bag

Folding Duffle Bag                          Polar insulated 24 oz water bottle with the CIBA logo.

One of the following books:

Chris Carmichael’s Food for Fitness

Bicycling Magazine’s Complete Book of Road Cycling Skills

The Cyclist’s Training Bible by Joe Friel

Weight Training for Cyclist by Ken Doyle and Eric Schmitz

**If you lead 2 traditional week end rides, you will earn the CIBA Star jersey instead of picking another incentive.

Return this form anytime after your ride but no later than November 12, 2011 to:

Sandy Lawson, 1289 West 136^th Street, Carmel, IN  46032.  Or  email to This e-mail address is being protected from spambots. You need JavaScript enabled to view it.

Please feel free to call if you have any questions. (317) 679-9261

FORMS MUST BE IN ON TIME OR YOUR AWARDS WILL NOT BE ORDERED!!!