Level Up Rider Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
An account at Box is required to receive discounts. If you haven't set up an account, please click here to register.
What's your jersey size? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Is this your first order or did you level up? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Sleeve Preference {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
What is your current standing? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Link to UCI/USA Cycle Profile {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Note: Please confirm your size using this size chart. Once printed, the size cannot be changed.
ORDER YOUR JERSEY
Item {binding ItemNumber}
JERSEY LEVEL ASSIGNED {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
ADD ONS [NAME / NUMBER] {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
SHIPPING {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
Please write down the name and number [if applicable] exactly as it should be shown on the jersey. Write "N/A" if not applicable. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
I understand that the discount level and perks received from Box are valid directly through boxcomponents.com ONLY. These discounts do not apply to track vendors, bike shops, or other third party vendors. Other exclusions may apply.
Signature {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }