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* Indicates required field |
*Your name:
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*Email:
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Street Address:
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Street Address continued:
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City:
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State:
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Zip:
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*Phone number:
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Cell:
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Your age: Height: ft. in. Weight: lbs. |
Riding gear sizes:
Helmet: Boots: Waist: Jersey: Gloves: |
Would you like to purchase any gear before your visit?
Yes No |
Select the adventure that you're interested in:
Training
Tours
Trials |
What specific date(s) for this adventure:
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Select your current dirt riding skill level?
Beginner
Novice
Experienced
Adv/Expert |
Select your physical condition:
Fit
Semi-fit
Not fit |
Select your bike option for this adventure:
MotoVentures to supply
Customer to supply |
Are you coming solo or with a group? If with a group, what are their name(s) and relationship to you?
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What is your riding/racing experience? On what bike(s)? What type of riding?
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What do you want to achieve with this adventure?
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Emergency contact:
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Emergency phone:
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Please indicate which video/photo package you would like to purchase:
Video Package-$100 (Professionally produced 20 minute video of your experience)
Video/Photo Package-$150 (Professionally produced 20 minute video and 20 still photos)
None |
Where did you hear about us?
Search Engine (e.g. Google, Bing, Yahoo!)
Article
Referral
Other:
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Do you know anyone who would be interested in our services? if so, please provide their email address: |
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