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Please submit your interest in being targeted again for the 2021/2022 cycle. Please note, all athletes targeted in 2020/2021 are automatically eligible for targeting for 2021/2022.

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* 1. First Name

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* 2. Last Name

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* 3. Your personal email

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* 4. If you are under the age of 18, your parent/guardians email

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* 5. Date of Birth

Date

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* 6. Primary Cycling Discipline

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* 7. Primary Coach's Full Name

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* 8. Primary Coach's Email 

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* 9. Hometown

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* 10. 2019 World Championship Result

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* 11. 2019 National Championships Result

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* 12. 2019 Provincial Championship Result

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* 13. Did you attend a NextGen or National Team training camp or race project in 2019?

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* 14. Did you suffer an injury or illness in 2019 that prevented you from competing at Worlds, Nationals, or Provincial Championships?

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