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Reservation Form
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Print this page and Fill it out.
Please print clearly or type the information for the HD BIKR Motorcycle TOUR you want to reserve. Tour Name ___________________________________________________ Tour Date _____________________________ Rider ( ) Co-Rider ( ) Rider’s Name ________________________________________________________________________________________ Address _____________________________________________________________________________________________ City ________________________________________________ State ______ Zip ______________ Tee Shirt Size ______ Home Phone ( _____ ) _________________________________ Work Phone ( ______ ) _____________________________ Fax ( _____ )_________________________________________ Email ___________________________________________ Age____________ Occupation ___________________________________________________________________________ Driver’s License # _____________________________________ State ________________ Expiration Date _____________ Years of Riding Experience _____________________________ Motorcycle Safety Course: YES ( ) NO ( ) Motorcycle Make _____________________________________ Year _____________ Model _________________________ Co-Rider’s Name _____________________________________________________________________________________ Address _____________________________________________________________________________________________ City ________________________________________________ State _______Zip ______________ Tee Shirt Size ______ Smoking ( ) Non-Smoking ( ) Special Needs: ( such as medical conditions, Allergies, medicine taken regularly,etc. ) ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ Emergency Contacts: Name ______________________________________ Relationship ________________ Home Phone ___________________ Name ______________________________________ Relationship ________________ Home Phone ___________________ Motorcycle Insurance____________________________________________________ Phone ________________________ Health Insurance________________________________________________________ Phone ________________________ |