Motorcycle Safety Program Registration 2025-July

Motorcycle Safety Program Registration

July 2025
Name*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Date
Age*
If you are under 18 years of age, you need a signed and notarized waiver from your parent or legal guardian with you on the first day of training. Or, you can bring your parent with you the day that you have your class and have them sign it in person prior to starting class. Please reach out to kstevens@glenoaks.edu to request a waiver.
Your Driver License #*
Driver's License State of Issue*
Gender*
Ethnicity*
Race
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
By checking this box, I attest that all information provided in this application is true and correct.
THERE WILL BE NO REFUNDS FOR THE MOTORCYCLE SAFETY TRAINING COURSE.

Course Key

	BRC	This is the course you want to take if you are an absolute beginner.
	BRC2	This is the course you want to take if you have some experience.

Please choose one course Only. You do NOT need to take both. Choose either the AM class OR the PM Class, NOT both. Thank you.

Courses*
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July 5th & 6th Morning Class
BRC July 5th & 6th 7am - 12pm Saturday & Sunday

$50.00 Quantity



July 5th & 6th Afternoon Class
BRC July 5th & 6th 12pm - 5pm Saturday & Sunday

$50.00 Quantity



July 10th & 11th Morning Class
BRC July 10th & 11th 7am - 12pm Thursday & Friday

$50.00 Quantity



July 10th & 11th Afternoon Class
BRC July 10th & 11th 12pm - 5pm Thursday & Friday

$50.00 Quantity



July 12th & 13th Morning Class
BRC July 12th & 13th 7am - 12pm Saturday & Sunday

$50.00 Quantity



July 12th & 13th Afternoon Class
BRC July 12th & 13th 12pm - 5pm Saturday & Sunday

$50.00 Quantity



July 17th & 18th Morning Class
BRC July 17th & 18th 7am - 12pm Thursday & Friday

$50.00 Quantity



July 17th & 18th Afternoon Class
BRC July 17th & 18th 12pm - 5pm Thursday & Friday

$50.00 Quantity



July 19th All Day BRC2
BRC 2 July 19th 7am - 5pm Saturday

$50.00 Quantity



July 20th All Day BRC2
BRC 2 July 20th 7am - 5pm Sunday

$50.00 Quantity



July 24th & 25th Morning Class
BRC July 24th & 25th 7am - 12pm Thursday & Friday

$50.00 Quantity



July 24th & 25th Afternoon Class
BRC July 24th & 25th 12pm - 5pm Thursday & Friday

$50.00 Quantity



July 26th & 27th Morning Class
BRC July 26th & 27th 7am - 12pm Saturday & Sunday

$50.00 Quantity



July 26th & 27th Afternoon Class
BRC July 26th & 27th 12pm - 5pm Saturday & Sunday

$50.00 Quantity



Side Stand Puck
$5.00 Quantity



T-Shirt
S, M, L, XL, 2XL, 3XL

$20.00 QuantitySize



Total

$0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

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Motorcycle Safety Program Registration

THERE WILL BE NO REFUNDS FOR THE MOTORCYCLE SAFETY TRAINING COURSE.