|Motorcycle Course Registration|
1. Tell Us About Yourself
(first name, last name)
City: _______________________ State: _____ Zip: ______________
Cell Phone: (___)______________ Alternate Number: (___)______________
Is it cool that we send you a text that is specific information pertaining to your class
Yes ___ No ___
Male ____ Female____
Date of birth: ____________________________
____ Check here if you are under 18 years of age
(A parental waiver form will be emailed to you.)
Under 5'3" ___
Over 6'4" ____
Which best describes your motorcycle riding experience (Please don't overthink this answer. The Basic Rider Course is designed for people with little or no knowledge of riding.)
___ I have never ridden a motorcycle before.
___ I have ridden in the past but it was a long time ago or on a smaller motorcycle/dirt-bike and I consider myself a beginner.
___ I have some experience riding and can shift and brake a motorcycle but I still would like to learn to become a better rider.
2. Pick a Location
|3. Pick a Course
__ Basic __ BRC2
4. Pick a Class Code
5. Determine Your Tuition
Enter your credit card information here:
___ Mastercard ___VISA ___DISC ___AMEX (Check One)
Credit card number: ________ - ________ - ________ - ________ Expiration: _______
6. Complete and Sign
Do you have a hearing, reading or other type of disability? __ Yes __ No
Do you have a primary language other than English? __ Yes __ No
"I have read, understand and accept the Course Descriptions and Course Requirements pages of this website".
You must sign below or your registration is invalid.
7. SIGN THIS SECTION
Student signature: _____________________________________________
8. Mail Us This Form (to the address above) or FAX to (508) 247-9010