1-Day Clinic Registration Form
Fields marked with an asterisk (*) are required.
Address Line 1 *
Address Line 2
Zip/Postal Code: *
Phone Number: *
Emergency contact name: *
Emergency contact phone number: *
Date of Birth (DD/MM/YYYY): * 01020304050607080910111213141516171819202122232425262728293031JanFebMarAprMayJunJulAugSeptOctNovDec19401941194219431944194519461947194819491950195119521953195419551956195719581959196019611962196319641965196619671968196919701971197219731974197519751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000
(If under 18, parents consent required)
Gender: * Male Female
Allergies (food or other): * yes no
If YES please describe in text area below:
Medication, conditions or previous injuries:
Tell us about your bike (brand/model/suspension or ridge/etc.) *:
How long have you been mountain biking? *:
Please name some of the trails you are comfortable riding right now. *:
What are you most interested in improving and/or learning while at Bike Ranch? *:
Clinic Date: * ---Request a DateJune 15, 2013
Request a Date:
(Bike Ranch will contact you to confirm your clinic date.)
Mountain Bike Camp Level *: Level 1Level 2
Level 1 = Beginner
Level 2 = Intermediate & Advance
Do you belong to a cycling club or organization? Yes No
If Yes please specify:
How did you hear about Bike Ranch:
Should you need to cancel your Bike Ranch reservation for any reason; the following cancellation policy will apply:
- 14+ days before your scheduled camp date: 100% refund, minus a $75.00/person admin. fee.
- 4 to 14 days before your scheduled camp date: 50% refund.
- Less than 4 days before scheduled camp date: no refund.
We reserve the right to cancel any camp. Full refunds will be made in these instances. We are not responsible for non-refundable airfare.
I understand and agree to the Bike Ranch Cancellation Policy above.
Type 'YES' in to confirm: *
Please read WAIVER and type 'YES' if you understand and agree: *
Please read BIKE CODE OF CONDUCT and type 'YES' if you understand and agree: *
You will receive an email confirmation of your registration once your credit card has been processed. We will also send you an information package that must be completed and returned prior to your arrival so that we know your riding level and experience.
please enter code above
If you need help registering for camp please CONTACT US: