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The undersigned participant or his or her parent or legal guardian if

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The undersigned participant or his or her parent or legal guardian if Powered By Docstoc
					 Please choose one per person                                                     The undersigned participant, or his or her parent or legal
 ___ 21 Years of age or more $250.00                                              guardian, if participant is under the age of 18, does
                                                                                  hereby certify the following: that the participant has a
 ___ 20 Years of age or less $150.00                                              valid driver’s license (or permit), and that participant will
 (This discount is offered in conjunction with the California Motorcycle Train-   use safety equipment and follow instructions by course
 ing Program. Valid identification is required)                                   personnel. The undersigned participant or his or her par-
                                                                                  ent or legal guardian for himself or herself, and his or her
                                                                                  heirs, successors, representatives and assigns (collectively
 Send Check or money order to:                                                    referred to as the “undersigned”), hereby forever re-
                                               SR-MT                              leases, discharges, waives, indemnifies, and agrees not to
                                               4751 Prospect Avenue               file legal action or suit. By signing this document, the
                                               Santa Rosa, CA 95409               undersigned hereby agrees and represents as follows: to
                                                                                  release the Santa Rosa Motorcycle Training employees,
 We can be reached by phone or e-mail at:                                         agents representatives and those government agencies
 Phone: 707-537-9860                                                              and other organizations affiliated (collectively referred to
 E-mail: questions@sr-mt.com                                                      as the “SR-MT”) with this course from any and all liabil-
                                                                                  ity, loss, damage, costs, claims and /or causes of actions,
                                                                                  including but not limited to all bodily injuries and prop-
  First choice class date: ____________________________
First choice ofof class date: ____________________________                        erty damage arising out of participation in the course
                                                                                  referred to in the above, it being specifically understood
  Second choice class date: __________________________
Second choice ofof class date: __________________________
                                                                                  that said course includes the operation and use by par-
                                                                                  ticipant and others of motorcycles, resulting from negli-
 If dates above are not available please sign me up for next
 available course YES: _____ NO: _____ Please Call: _____                         gence or any other manner of cause of action, SR-MT its
                                                                                  employees, agents, representatives and other organiza-
Name: __________________________________________
 Name: __________________________________________                                 tions affiliated with this project, and hold them harmless
                                                                                  for result of undersigned’s participation in said course.
Address: _________________________________________
 Address: _________________________________________                               This indemnification shall include attorney’s fees in-
                                                                                  curred in defending any claim or judgment incurred in
City: __________________________ State: _____________
 City: __________________________ State: _____________                            the negotiation of any settlement. The undersigned vol-
                                                                                  untarily elects to assume and does assume any and all
Zip: _______________________ Age: _________________
 Zip: _______________________ Age: _________________                              risk of injury, harm, and/or damage resulting from or
                                                                                  connected with his or her participation in this course. It
 Date of Birth: ______________________                                            is understood and agreed that the undersigned shall have
                                                                                  the opportunity to consent to any settlement, provided,
E-mail address: ____________________________________
 Phone #: _________________________________________                               however, that such consent shall not be unreasonable
                                                                                  withheld. The Motorcycle Safety Foundation and the
 I want to learn on a: Motorcycle ______                 ____________
                                                        Scooter ______
                                                                                  California Motorcyclist Safety Program and other organi-
              Family / Friend
              Family / Friend        ______________
 Refered by: _______________________________________                              zations are also protected and represented by this release.


 I have read and understand this entire document, I understand that it contains a release of all claims, waiver of liability and my
 assumption of all risk. I voluntarily sign my name evidencing my acceptance of all provisions in this document. I understand that
 there will be NO REFUNDS for any reason. I understand there is a $150.00 re-booking fee to request for class date change if
 less than 5 business days prior to the start of the class (Subject to change, current policies can be found at our website).

 Signature of Participant: _______________________________________ DATE: ______________

 Signature of Parent or Legal Guardian: ___________________________________________ DATE: ______________
      Important Eligibility and                                                       Q&A
      Registration Information                                                                                                  the phone with a VISA, MASTERCARD, or check debit
                                                                                                                                card. You may also fill out the registration application,
                                                        SR-Motorcycle Training Provides....                                     sign it, and mail it with a check or money order for your
SR-Motorcycle Training                                                                                                          training fee. We keep class size small, so please register
                                                        We provide the motorcycles for the range training, along with hel-      early, as classes fill-up fast. Whether you call or mail in
Is the local organization with conducts California      mets and a controlled learning environment.                             your registration, your class assignment will be sent by
Motorcycle Training, a state-wide program for
                                                        What is the cost                                                        return mail.
beginning and experienced motorcycle riders
sponsored by the California Highway Patrol. Class-      The course costs are $250.00 for those 21 years of age or older,        Failure to attend your pre-registered class or cancellation
rooms and riding sessions are held at the Sonoma        $150.00 for those 20 years and younger.                                 less than 5 business days before the first class will require
County Fairgrounds. The Department of Motor                                                                                     a rebooking fee of $150.00 payable up front.
Vehicles now waives it’s riding skills test require-    How often are classes held
                                                                                                                                         There are not refunds for any reason
ments for a Class M1 or M2 license for applicants       We offer several classes throughout each month year round you
who have successfully complete the Course.              may visit our website or call us to get most current class schedules.   We do not guarantee you will master the written or
                                                                                                                                riding skills presented in this course. Most of the time
Length of Course                                        Website: www.SR-MT.com                                                  students successfully complete the course their first
The course include five hours of classroom train-       Phone: 707-537-9860                                                     time, some need additional training. If you do not pass
ing and ten hours of on cycle experience in a two                                                                               the course your first time or have been asked to leave
day format on weekends or a two week format on          What if I am under 18                                                   and invited to return, you may repeat the course at
weekdays. It begins with a classroom lecture and        On the first session a parent or legal guardian must be present to      no additional charge provide it is done so within a 3
discussion or riding range first depending on which     sign all forms.                                                         month time period. However if you do not re-attend
format you choose. Please call ahead for exact                                                                                  within the 3 month grace period, you will have for-
format being used at that time, such as Summer          To enter any motorcycle/scooter class you must be:                      feited your spot. And will have to pay full price in
schedule or Winter schedule.                            •    At least 15 years 6 months old                                     order to re-attend.

Each exercise in each session builds cumulatively                                                                               How big are the motorcycles/scooters that are
                                                        •    In good health
on the skills and information from the preceding                                                                                used
exercises and discussions. Therefore, each student      At the first classroom/range students younger than 18 MUST have a
                                                                                                                                We use a variety of motorcycle styles from a standard
must attend all class or range sessions in order to     parent or legal guardian accompany them to the classroom/range in
                                                                                                                                motorcycle style to dual sports. They vary in height and
complete the course and be issued a DL389 form          order to sign waivers.
                                                                                                                                weight; engine sizes from 80cc to 500cc including
for DMV.
                                                        What is the ratio of students to RiderCoaches                           scooter.
What the Student needs to provide
                                                        We never exceed a ratio of 1 RiderCoach to 6 students in a range        Do you have classes in the rain
The student must have eye protection, sturdy full       session
                                                                                                                                We ride rain or shine, hot or cold, clear or foggy. How-
fingered gloves, over the ankle footwear, and long
                                                        Do you offer One to One training                                        ever a class can be canceled if weather dictates it.
sleeves shirt or jacket.
                                                        Please call for more information on this subject. We do have such       Have further QUESTIONS
To enroll in any motorcycle/scooter class
                                                        training however it is NOT PART OR ASSOCIATED IN ANY
you                                                                                                                             707-537-9860
                                                        WAY WITH ANY TRAINING MATERIALS from Motorcycle
•    Have a valid drivers license or a valid learners   Safety Foundation or the California Motorcycle Safety Program.
     permit or                                          Again please call for more information on this subject.

•    Proof of successful completion of a drivers        How do I register for the Basic or Experienced rider
     education program                                  course

                                                        The fastest and easiest way is to call our office, and register over

				
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