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2. 

   You can submit this form daily during the Kenosha County Bike to Work Weeks (June 3-17, 2023). Only one submission per person per day will be counted. No submissions will be accepted before midnight of June 3 or after midnight of June 17. Winners will be selected in a random drawing. Prize information to be announced soon.

4. First Name*
5. Last Name*
7. Email Address*
8. Phone Number*
10. Address1*
12. Address2
14. City*
15. State*
16. Zip*
18. Where did you ride to?
19. How many miles?
21. How often do you bike to work?*
    -- Select One --Every work day3-4 days per week1-2 days per week1-3 days per month1-11 days per year
23. What is your favorite place to bike in Kenosha County?
25. Tell us about improvements you would like to see to Kenosha County's system of bike trails:
27. Upload a Photo (optional)
29. Agreement*

    1. I agree to the following terms:

    By submitting images to Kenosha County, all participants grant Kenosha County, its employees, affiliates and assigns, the right to print, publish, broadcast and use in any manner and at any time or times, in any media now known or hereinafter developed, the participant’s image, name, photograph and any language contained therein, for public use and information without additional consideration or compensation. Participants further release and agree to hold harmless Kenosha County, its employees, affiliates and assigns, from any and all liability, claims or damages arising out of or relating to participant’s submission. All photographs and images submitted will become the property of Kenosha County and will not be returned to the submitter.

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31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit

* indicates a required field