Tour Registration


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First Name
Last Name
Address
City
State
Zip
International Address? Use this space:
Day Phone
Night Phone
Email Address
Type of Motorcycle
Years of Experience

How did you learn about Stayin' Safe training tours?
I'd read Larry's Stayin' Safe columns in Rider Magazine
Eric's "Riding Well" columns in Rider Magazine
I read about them in a magazine article
     Which Publication?  
I saw an advertisement for them
     Which Publication?  
Another rider told me about them
Surfing the internet or linking from another web page
 
Payment

Important: Registrations (including standby registrations) will be held for a maximum of 72 hours while we await your deposit!)

Check appropriate boxes:

I would like to add video component to the tour for $100 (not available on all tours)

I am booking with another rider and would like the shared room discount of $50

I am riding with a passenger for an additional $200

I will pay with PayPal (preferred)

I will phone in a credit card authorization to to Stayin' Safe at 724-771-2269

I will send a check by overnight or two day courier service (please - do NOT use 1st class mail!)

Policy I have read, understand, and certify my motorcycle exhaust system is in compliance with your Sound Emission Policy

Are you an AMA Member?

Please enter the two words you see in the space below:

  
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