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Learn to Ride--Adults Application
Learn to Ride--Adults Application Form
* Indicates required information.
* Name
* Phone Number:
* E-mail:
Age:
Gender:
M
F
* Do you have a bicycle and helmet to use at the class?
Y
N
If no, would you like to borrow both from Bike New York?
Y
N
If you wish to borrow a bike, please specify your height.
3
4
5
6
7
Feet
0
1
2
3
4
5
6
7
8
9
10
11
Inches
* Date of class for which you are registering:
* Location of class for which you are registering:
Please indicate which time slot you prefer. Select “No preference” as your first choice if you do not have a preferred time slot.
First Choice:
No Preference
9:30-11:30 a.m.
Noon-2:00 p.m.
2:30-4:30 p.m.
Second Choice:
No Preference
9:30-11:30 a.m.
Noon-2:00 p.m.
2:30-4:30 p.m.
Third Choice:
No Preference
9:30-11:30 a.m.
Noon-2:00 p.m.
2:30-4:30 p.m.
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News article (where?)
Ad (where?)
Website (which one?)
Other (how?)
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