Pioneer Valley Rider Training, Inc.

Mailing Address:
PO Box 991

East Longmeadow, MA  01028

 

COURSE REGISTRATION FORM

 

1.  Tell Us About Yourself (please print legibly)

 

Name:___________________________________________________________

 

Address:________________________________________________________

 

City:_____________________________State:________Zip:____________

 

Day Phone: (_____)______________ Eve Phone: (_____)_____________

 

Date of Birth: ______________  Email: ___________________________

 

Age Category:  __ Under 18   __ 18-20   __ Over 21      MALE   or  FEMALE

 

Social Security #:___________________________ Driver’s License #:____________________________

 

 

2.  Pick a Course   __ Basic RiderCourse  __ Experienced RiderCourse

 

3.  Pick a Class Code and Group

·    Put two CLASS CODES below (i.e. PV01, PV02 – see our brochure or website (www.pvriders.com) for class schedule and codes)

·    When your registration is accepted, you will be mailed a confirmation letter that has detailed directions to the training site and reminds you of what you need to bring.  You are not confirmed in any class until you receive this letter.

 

CLASS CODES:  1st choice:_________ A or B 2nd choice:_________ A or B

 

 

4.  Determine Your Tuition

$280 for the Basic RiderCourse

$150 for Experienced RiderCourse

 

Tuition Enclosed:____________

Please make check payable to Pioneer Valley Rider Training, Inc.

 

 

5.  Complete and Sign

Do you have an inseam less than 26 inches?                        __Yes __No

Are you less than 62” tall?                                       __Yes __No

Do you have a hearing, reading, or other type of disability?      __Yes __No

Do you have a primary language other than English?                __Yes __No

 

If you answered YES to any of the above questions, please call the office prior to registering to discuss if we can accommodate your special needs.

 

Are you a member of Barnes ANGB?                                  __Yes __No

(If Yes, Supervisor:_________________________ Phone ext:________)

 

Have you ever ridden a bicycle?                                   __Yes __No

Have you ever driven a motorcycle?                                __Yes __No

 

“I have read, understand and accept the Course Descriptions, Policies and Conditions as stated in this document.”

 

You must sign below or your registration is invalid.

 

 

Student Signature                                                    Date

 

 

6.  Mail this page along with a copy of your motorcycle learner’s permit (if you have it) to the address above.  We must receive your learner’s permit at least two weeks before class begins.

 

 

Course Descriptions

 

Basic RiderCourse

This is an approximately 15 hour course (5 classroom, 10 riding).  Training motorcycles (250cc or less) and course books are provided to students.  Loaner helmets are available for students without their own DOT approved helmet.

 

Classroom Sessions Cover:

·    The Challenge of Motorcycling

·    Motorcycle Controls

·    Rider and Motorcycle Preparation

·    Basic Riding Skills

·    Street Strategies

·    Advanced Riding Skills

·    Special Riding Situations

·    Dangers of Impaired Riding

 

Practice Sessions Cover:

·    Straight Line Riding, Turning, Shifting, Stopping

·    Advanced Turning and Braking Techniques

·    Crash Avoidance Maneuvers

 

Tuition - $280

STUDENTS MUST ATTEND ALL CLASSROOM AND PRACTICE SESSIONS AND PASS THE REQUIRED EVALUATIONS TO GRADUATE FROM THIS COURSE AND RECEIVE A COURSE COMPLETION CARD.

 

 

Experienced RiderCourse

This is an approximately 6 hour course designed for those students who have passed the Basic RiderCourse and/or who have several years and several thousand miles of riding experience.  The course includes 9 riding exercises and pertinent group discussions and allows each student to meet one or more of the following objectives:

 

Skills Practice

For motorcyclists who recently passed the Basic RiderCourse but wish to further develop their riding skills before truly taking to the road

 

License Waiver

For motorcyclists who have been riding with a permit but for whatever reason have not obtained their license endorsement.  STUDENTS WHO DESIRE THE LICENSE WAIVER MUST PASS THE REQUIRED EVALUATIONS.

 

Skills Plus

For motorcyclists (and passengers if desired) looking for extra skills training or perhaps a skills refresher after a long winter's break from riding.

 

Students must use their own motorcycles which must be properly insured, registered and inspected and pass an instructor’s pre-ride check.  A copy of the pre-ride check will be mailed to students before the course.  Course book provided for use during the class.

 

Tuition - $150

 

STUDENTS MUST PASS BOTH A WRITTEN AND RIDING EVALUATION TO OBTAIN THE LICENSE WAIVER AND/OR COURSE COMPLETION CARD.

 

POLICIES AND CONDITIONS

 

Please read this page prior to signing Page 1 of the Registration Form.

 

Both the Basic and Experienced RiderCourses emphasize the risks involved with riding a motorcycle.  These risks also exist while one rides during the course.  Students registering for the Basic RiderCourse must be able to, at minimum, balance and ride a bicycle.

The instructor may dismiss students unable to keep pace with the class, or who pose a hazard to themselves or others.  There will be no refunds to the student, pro-rated or in full, should the instructor dismiss them.

Statewide approximately 95% of students successfully complete this course their first time.  Please understand that these courses have a group-learning format that limits the ability of the instructors to provide individual instruction to students. These courses are mentally and physically demanding, and weather conditions can increase the stress on students.

Students are covered by a limited medical and liability insurance policy during their participation in a course, but may wish to review and add to their existing auto/motorcycle and medical insurance.

Student motorcycles to be used in the Experienced RiderCourse must pass a pre-ride inspection given by the instructors.  The Experienced RiderCourse student also needs proof of motorcycle insurance, proof of medical insurance, a completed "Waiver Form" supplied by the sponsor and parental permission (depending on the rider's age).

Refunds will be given:

·          With 10 business days notice in writing (US mail, e-mail or fax), less a $50.00 service fee.

·          If we cancel class due to extreme weather conditions, an inability to access necessary facilities or other unforeseen problems.  Such cancellations are very rare and will result in a full refund of tuition.  Please remember that courses run rain or shine!

 

Refunds will not be given:

·          If you cancel less than 10 days prior to class.  (You may reschedule your course instead - see below)

·          If you have previously rescheduled  (see below)

·          If you arrive late to class or practice sessions and are not allowed to participate

·          If you miss any segment of the course

·          If you do not pass the written or riding skills evaluations

·          If you are dismissed by a RiderCoach

·          If you leave voluntarily

 

Students may reschedule another class, only once, within the calendar year on a space available basis.  All such reschedule requests must be in writing (US Mail, e-mail or fax) and received in the office prior the start of the original class and will be subject to the following service fees:

·          $50.00 – If received more than 10 days before the start of the original class

·          $100.00 – If received 10 days or less before the start of the original class 

 

Students may retake a riding skill evaluation only once for any one class.  Re-tests are scheduled on a space available basis within 14 days of class completion.  Re-tests are subject to a $40.00 service fee.

 

Students who wish to qualify for a motorcycle license/endorsement must obtain a Massachusetts motorcycle permit and submit a clear photocopy of the permit to this office at least two weeks before the first class session.  Permits cannot be post dated and must not expire within two weeks after course completion.  Students under the age of 18 who wish to qualify for licensing must also have a driver education certificate issued by the Registrar and have held their driver or motorcycle learners permit for a full 6 months prior to the application for the endorsement or license.

 

The following service fees apply:

·          $15.00 to replace a lost course completion card

·          $25.00 to replace a lost Certificate of Training

·          $25.00 for submitting a check that is returned unpaid (bounced)

 

Service disputes must be submitted in writing within 30 days of the course completion date.

 

You must call this office prior to registering if:

·          Your inseam is less than 26" or you are less than 62" tall

·          You have a physical, medical or learning disability

·          Your primary language is not English

 

Although we make every effort to provide accurate and timely information, we cannot be responsible for misprints or outdated information contained on this form or our website due to technical issues beyond our control.  Please call our office with any questions at (413)525-0049.