Motorcycle Safety
Registration Form

Name: * Required
First Middle (Full) Last
Address: * Required
Street Address City State ZIP Code
Age: * Required
Email: * Required
Phone: * Required
Driver License #: * Required
Birth Date: * Required
A copy of your Driver License is required to register for a Motorcycle Safety Course. Please attach below: * Required
Max. file size: 5 MB.
If you do not have a scanner, you may need to use one available through the Glen Oaks library, your public library, or through a retail establishment that offers a document scanning service.
Maximum file size - 5 mega bytes.
Please select the class that you would like to register for (you only need to sign-up for one class): * Required
- BRC: Saturday, June 4th (0 spots left)
- BRC: Saturday, June 18th (0 spots left)
- BRC: Sunday, June 5th (0 spots left)
- BRC: Sunday, June 19th (0 spots left)
- BRC: Saturday, June 11th (0 spots left)
- BRC: Saturday, June 25st (0 spots left)
- BRC: Sunday, June 12th (0 spots left)
- BRC: Sunday, June 26th (0 spots left)
The BRC start on either a Saturday or Sunday morning, depending on what date you signed up for, both classes start at 7:00 am ending at 5:00 pm.
If the course you desire to sign up for has no spots left, you will need to select another course date/time or continue to check back to see if anyone from the filled course has dropped.
Will you be paying your registration fee yourself? * Required
- Yes
- No
If not, please list the name of the individual who will be paying your registration fee:
Do you intend to pay the registration fee for another applicant?
- Yes
- No
Name of the additional applicant(s) whose registration fee you will be paying (besides yourself):
Please select the class(es) that the person(s) you are paying for has enrolled:
- BRC: Saturday, June 4th
- BRC: Saturday, June 18th
- BRC: Sunday, June 5th
- BRC: Sunday, June 19th
- BRC: Saturday, June 11th
- BRC: Saturday, June 25st
- BRC: Sunday, June 12th
- BRC: Sunday, June 26th
Comments
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Motorcycle Safety Registration Form

Motorcycle Safety
Registration Form