TRACKFEVER - For sportbike maniacs !!!

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First Name*
Last Name*
Birthdate (DD-MM-YYYY)*
Address
City
Postal Code
Home phone		Cell phone
Email*
Emergency contact name
Emergency contact number
Your bike (Make and Model)
Membership card
Activities chosen	Lessons Trackdays Racing
Participant number choices	1st 2nd 3rd

Riding lessons level wanted	Level 1	Level 2	Level 3
Choice of date (DD-MM-YYYY)	Choice 1	Choice 2	Choice 3

Classification wished for track days	Novice (Green) Intermediate (Yellow) Expert (Red) Racer (Black)
Dates (DD-MM-YYYY)	1	2	3
	4	5	6
	7	8

Class wished for racing	1	2	3
Dates (DD-MM-YYYY)	1	2	3
	4	5

Janvier 01, 2012
Happy Holidays wishes ...

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