Motorcycle Safety Program Registration 2026

Motorcycle Safety Program Registration

2026
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.

Payment Methods

Debit or Credit Card

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

Motorcycle Safety Program Registration