Booking Form

Note - If you do not see a suitable date below just give us a ring on   0800 BIKETRAINING (0800 245387) to see if we can make an alternative arrangement. * = Required field

A separate booking is required for each person attending a course

Course	Confident Rider
*Date/Venue/Price	Wednesday, 26 June 2013 1:00:00 p.m. - Te Atatu - $190Thursday, 27 June 2013 1:00:00 p.m. - Te Atatu - $190Friday, 28 June 2013 9:00:00 a.m. - Te Atatu - $190Friday, 28 June 2013 1:00:00 p.m. - Te Atatu - $190 Make sure you have selected the correct course and venue!
*Title	MrMrsMissMs
*First Name	(as it appears on your licence)
*Surname	(as it appears on your licence)
*Date of Birth	12345678910111213141516171819202122232425262728293031JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember19051906190719081909191019111912191319141915191619171918191919201921192219231924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999
*Street
*Area
*Town
*Home Phone No.
Mobile Phone No.
*Email Address
*Motorcycle  Experience	I have little or no experience of motorcycle riding    I have ridden motorcycles a few times    I ride or have ridden motorcycles on a regular basis
*Scooter  Experience	I have little or no experience of scooter riding    I have ridden scooters a few times    I ride or have ridden scooters on a regular basis
*Payment  Options	I would like to pay by VISA     I would like to pay by MASTERCARD    I would like to pay by gift voucher or cash
	Note: all payments are made in New Zealand Dollars to Riderskills (New Zealand)
Additional   Information	(Max. 240 characters)
*	I have read and agree with the Terms & Conditions / Cancellation & Refund Policy and agree to be bound by it's content
*	I would like to be emailed from time to time with details of group rides and discounted training promotions on offer from Riderskills