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Location:
Oakland
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Service:
1 student, 90 minute
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Instructor:
Anthony DiSalvo
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Date/time:
Sun, Jun 9 at 12:15 PM
(PDT)
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Price:
$180
(pre-payment required)
Please review our
LIABILITY WAIVER
, accept it using the check-box below, then
complete the rest of the form.
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Last name
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I ACCEPT THE LIABILITY WAIVER
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Today's date (MM/DD/YYYY)
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Lesson type requested
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Learn To Ride (balance & pedal)
Handling Skills (off-street)
Ride-Along (on-street)
Custom Coaching
Home city
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Student name(s) [first & last]
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Student age(s)
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Student height(s)
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So we can bring the proper size bikes
We will bring bike(s)
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Bringing a bike is optional
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Yes
Describe bike(s)
Only if bringing bike(s). For kid bikes, wheel size(s)?
EMERGENCY CONTACT full name
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Must be reachable by mobile phone during the lesson
EMERGENCY CONTACT mobile phone
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Time or date flexibility/preference?
Different start time and/or date, if it opens up
Additional requests or notes?
Health, range of motion, special needs...
How did you hear about us?
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