2020 Team Peacock Rider Agreement & Deposit Form
1. UIU REPRESENTATIVE. As a Team Peacock rider I am a representative of Upper Iowa University. I will
proudly wear UIU Team Peacock gear and conduct myself in a professional manner at all times during the
ride. I will be respectful of the property of all overnight hosts.
2. THE TEAM. I agree to be an active member of Team Peacock. I will help and support other riders along the
way, when possible.
3. FUNDRAISING / PAYMENT. I understand Team Peacock is a fundraising venture for Upper Iowa University.
I agree to meet my minimum fundraising goal no later than Friday, July 17, 2020. If I have not reached my
goal by that date, I will provide a credit card payment to the Alumni Office, prior to my RAGBRAI departure
with Team Peacock. In addition, I understand I am responsible for a non-refundable Camp Fee deposit
payment of $125 for week-long riders or $30 per day for daily riders due no later than June 1, 2020.
4. WITHDRAWAL. If for any reason, I need to remove myself from the team after June 1, 2020, I understand
that I will not receive my Camp Fee deposit back unless I secure a replacement rider who will also complete
my fundraising goal.
Fundraising Category & Goal Amount:
UIU Affiliation Week-long Rider Goal Daily Rider Goal (no more than 3 days)
Friend of UIU $1,000 $250 x ______ days = $ ______
Faculty, Staff or Board of Trustee rider $750 $200 x ______ days = $ ______
UIU Alumni, Student, Parent, or Non-rider $500 $150 x ______ days = $ ______
Fundraising Designation: I choose to direct my fundraising dollars to the following UIU fund, project or program:
______________________________________________________________________________________________
(If left blank, funds will be directed to the UIU Fund.)
Team Peacock Rider: _______________________________ _______________________________ ________
(printed name) (signature) (date)
Deposit:
Enclosed is my Camp Fee deposit of $125 for
week-long or $30 per day for daily rider
I have paid my Camp Fee online at
uiu.edu/SupportTeamPeacock
(Select "Team Peacock General Fund")
Additional Rider Info:
Mailing Address: _______________________________
City, State, Zip: ________________________________
Cell Phone #: __________________________________
E-mail: _______________________________________
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Please return this completed form to the UIU Alumni Office:
P.O. Box 1857, Fayette, Iowa 52142 or email to luzumb@uiu.edu
Rider Agreement forms are due June 1, 2020
Emergency Contact: ____________________________ Emergency Contact Cell #: _______________________
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