Cornering Confidence Trail Braking Camp - Registration Form Which course are you registering for? (Choose from list) * Click here and choose... Trail Braking Lesson (1.5 hour Private Lesson include venue - date - time in Special Notes section) Waiting List - included venue and date in the Special Notes section First Name Last Name Address1 Address2 City State Zip Code Age * E-Mail * Cell Phone Home (Alternate) Phone Emergency Contact Name Emergency Contact Phone Relevant Medical Info (bee sting allergies, asthma, etc.) List any physical limitations you have riding a motorcycle (if applicable) Make and model of your motorcycle(s) Your Height is less than 6’6" (Important only for trail braking camp bike fitment) * Yes No Your Weight is less than 275 lbs. (Important only for trail braking camp bike fitment) * Yes No Total Years of Riding Experience Approximate Miles Ridden per Year What is your usual road riding pace? Comfortable Brisk at Times Intense Are you left or right handed? Right Left What motorcycling skills or techniques do you most want to develop? You will have appropriate medical insurance at the time of the course? * Yes No Are you a current AMA member? No Yes AMA # if member T-Shirt Size S M L XL XXL How did you hear about this Street Skills course?
Check box if you have a copy of Jon’s "Cornering Confidence" book
Check box if you’re already enrolled in Jon’s "Cornering Confidence" online course. How many wheels does a motorcycle have? *
1 + 2 = ? Please prove that you are human by solving the equation *