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BICI-ESCUELA
Reservation Form
Date:
*
/
Month
/
Day
Year
Date
Full Name:
*
Phone Number
*
Please enter a valid phone number.
E mail:
*
example@example.com
Other Notes:
Place of preference for learning
Parque Dr. Celso Barbosa, Santurce
Plaza La Convalecencia, Río Piedras
Appointment
*
Appointment is for:
Day 1
Day 2
Day 3
Other
Payment Method
*
ATHMóvil Negocio (/CulturaBicicleta)
PayPal.me/culturabicicleta
Venmo @culturabicicleta
Other
IMPORTANT AFFIRMATIONS
Clicking the box certifies that you agree with each of the following, necessary to go forward with the learning experience.
*
I certify that my health conditions are optimum and adequate, and that I am capable of riding a bicycle with total control and awareness of my senses.
*
I am responsible for being respectful towards all Puerto Rican norms, rules and laws regarding transit and transportation, applicable to all people conducting a vehicle, and also, the rights and duties directed specifically towards cyclists.
*
I will always be careful when riding close to other people using the sidewalk or crossing the street. It is my responsibility to lower my speed and keep reasonable distance from pedestrians.
*
I will not make Cultura Bicicleta Coop responsible for any lawsuits, reclamations, loss, lesions, or harm, I or any other being(s) suffer(s), as a consequence of biking.
*
I understand that all of the information I am providing will solely be used for purposes directly related to this transaction.
*
It will be my responsibility to take care and make up for any resulting damages to the bike(s), and/or other being(s), and/or private property, caused by me or anyone biking under my supervision.
Signature:
*
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