Registration Form

CAMP: COMOX VALLEY WOMENS CAMP Dates: Aug 10-11 2013

Name: ___________________________________________________ DOB: _______________________ Age: ____________ M/F: _______ Address:_________________________________________________ Phone: (H)______________________(Cell)_____________________ Email: ___________________________________________________
CAMP INFO How did you hear about DRIFT? Are you a Bike club member? How far have you travelled? Which accom are you using? Food allergies: Safety Emergency Contact Name: No/s: Relationship: Which one?

Current medications or injuries: Allergies, previous injuries, ongoing medical conditions SKILLS QUESTIONAIRE How long have you mountain biking? What type of bike/s do you ride? What kind of riding do you like to do? What previous MTB or other instruction have you had? What trails do you ride locally? BC? What skills would you like to learn? What is the most challenging experience you have biking? How often do you ride?

Consider your riding and put an X next to the skills that you are successful at 70-100% of the time. Leave all other skills blank. If you are unsure about what a skill is, put a ? in the box and we will chat more. Wide bridges Narrow bridges Corners in bridges Skinnies Teeter totters Smooth tight corners Smooth switchbacks Tight descending PAYMENT OPTIONS If you are using a promotional or discount code, enter it here: If you are using a gift certificate, enter it here: Payment type (Circle): Visa/MasterCard PayPal Gift Certificate or Promo Holding track stand Smooth high speed corners Braking under pressure Small drops Drops 5-7ft Drops > 8ft Riding rock Riding steeps Riding sharp rock Front wheel over curbs Front wheel over small obstacles Front wheel off ground Lifting rear wheel Pedaling front wheel lift Wheelie drops Bunny hops Smooth seated climbing Smooth standing climbing Technical single track climbing Shifting under pressures Over obstacles on climb Getting up on ledges Small manuals Bike length manuals Held manuals Small jumps to transition Medium jumps to transition Large jumps to transition. Small gap jumps Medium gap jumps Large gap jumps Style tricks

We will contact you to for your preferred payment option once we have processed your registration. CANCELLATION POLICY- Over ten days before the camp date: 100% refund. Ten to four days of the camp date: 50% refund. Three or fewer days before the camp or "no show": no refund. Program registrations are non-transferable. Please indicate your agreement to these policies by writing YES in this box: Mountain biking is an adventure sport with inherent risks. All participants must sign a waiver prior to the start of any instructional sessions or course. I agree to sign a Waiver, on-line or in person, prior to the beginning of the course. Write YES in this box.

DRIFT use only. Date Waiver completed: Payment processed: Payment type: Receipt provided: Group allocation:

____/____/2013 ____/____/2013 Visa/MasterCard No:

PayPal

Gift Certificate or Promo ____/____/2013