Ride Forms

All forms needed to participate or support this year's ride can be found on this page.

Registration Form to Type, Save and Email
To register for the ride, download the application template, type it, save it to your computer, and then email to copscyclingforsurvivors@gmail.com .  Make sure you read the back page and click the waiver box.  Typing in your name as your "electronic signature" is acceptable.  We do not need an actual signature.  Click below for the electronic registration form.




Donations are the heart of our fundraising efforts! We give as much as we can back to survivors and organizations supporting survivors.  Participants are required to fundraise $75 per day that they ride. The registration fee is separate from fundraising. Each registered rider will have a fundraising campaign page on the website with the minimum required fundraising goal based on the number of days they plan to ride. Riders are encouraged to exceed their goal.

Sponsor Form:
If you would like to sponsor a rider but do not wish to donate online, please print the sponsor form and mail it to Cops Cycling, P.O. Box 597, Ellettsville, IN 47429 Click here for the Sponsor Form.

New Grant and Grant Renewal Form:
Organizations seeking funding from Cops Cycling for Survivors Foundation must submit an annual application by September 1st.
Click here to download a Grant Application.


If there are any questions please contact Monica Zahasky at 812-727-0725.

PO Box 597, Ellettsville 47429    copscyclingforsurvivors@gmail.com; ispdaverich2007@gmail.com    812-727-0725

Cops Cycling for Survivors © 2022. All Rights Reserved. Terms of Use. Privacy Policy.

an imavex website