Dyfed Powys Police
BikeSafe Weekend Workshops
Application Form |
| Name: |
| Address: |
|
| Post Code: |
| Telephone Number: |
| Age Group:
|
| Any post test training? |
| Year you passed the motorcycle test: |
Have you recently returned to motorcycling
after a
period of absence? YES/NO |
| Where did you hear about BikeSafe? |
| Approximate Annual Mileage Per Year? |
| Motorcycle Details: |
Make: |
Model: |
|
Please circle the dates you prefer
for our 2008 Rider Skills Workshops
17/18 May
14/15 June 'Ladies Only Weekend'
21/22 June
20/21 September
|
|
| The cost will be £80.00 per
rider. Please enclose a cheque made payable to Road Safety Wales.
The cheque will not be cashed until you have been allocated a place
on one of the workshops - it will then become non-refundable. Please
note that if you intend to bring a pillion passenger there will
be an additional charge of £10.00 per day. |
| I intend to
bring a pillion on None/One/Both days (delete as applicable) |
Cheque enclosed £
|
| Please specify
any dietary needs. |
|
|
Please read the following
declaration and sign below
I understand that the workshops
will include on road riding, and that it is my responsibility
to ensure that all relevant legal requirements will be complied
with and that the Dyfed Powys Police will not accept any liability
for loss, injury, theft or damage whilst on police property.
This is not a training course.
Signed..........................................Date............................... |
Please return the completed form
to:
J Bibby, Road Safety Wales, 2 Cwrt y Parc, Parc Ty Glas, Llanishen,
Cardiff CF14 5GH |
Tel: 029 202 50600 email: jbibby@rospa.com
|