Dirt Soldiers Mx Training School Registration!

Lets Moto
Professional & Personal Motocross Coaching with Scoob on the Disciplines of: MX Techniques, Athletic Training, Mental Training.
Contact: Scoob

Phone: 814-330-2058

Email: mxscoob@gmail.com
Dirt Soldiers Mx Training School Registration
Registration Fees will be paid through PayPal and must be completed in order to complete registration process online. YOU DO NOT need to have a PayPal account to use this system and may use credit card or debit card. If you do not have a Paypal account you may sign in as a "guest".

Only one student may be registered at a time. There is a $50.00 deposit required to hold spot in school.
Choose Your Coaching Below
1-on-1 Coaching / Personal instruction with Scoob on any discipline: MX Technique, Athletic Training, Mental Training. 4-Hour minimum for in-person coaching.

1-on-1/ 4hr $200
Two-on-one Coaching/ 2 students - one coach, personal instruction on any discipline: MX Technique, Athletic Training, Mental Training. 4-Hour minimum.

2-on-1/ 4hr $150 Each
Small Group Coaching: Groups of 3 or more. Either you gather your own group or Dirt Soldiers Mx Training Academy will group you with similar level students. This is a cost effective option yet one of the most productive by incorporating personalized instruction along with the dynamic power of a group.

3 or more students/ 4hr $100 Each
Appointment
Riders Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Birth Date*

MonthDayYear
Current Age:*
Gender:*

MaleFemale
Phone Number*

Area CodePhone Number
E-mail Address where you'd like to receive confirmation and information:*
Bike Size*
Students Skill Level*
Please provide at least 1 emergency contact.
1st Emergency Contact Relationship:*
1st Emergency Contact Daytime Phone Number:*

Area CodePhone Number
1st Emergency Contact Evening Phone Number if different:

Area CodePhone Number
Liability
I hereby declare that it be my intent while at the Motocross School to drive/ride at high speeds and to test my driving/riding skills and to check the performance of the vehicle I am driving/riding. I affirm that I am going to engage in these potentially dangerous activities of my own volition.

I hereby affirm that I enter this school fully aware of the possible hazards to my person and property therein, and I assume all risks and responsibilities upon myself. I confirm that when I enter this school of Motocross, I do so as a voluntary participant in the activities conducted therein.

If I am injured, in any manor, while I am in school I will grant a full and unconditional release of any injuries sustained to my person to all track owners, participant, officials, employees, promoter, instructors or any others who are responsible for the activities in the school.

On behalf of myself, my heirs, executors, or administrators, I agree to hold harmless and indemnify all track owners, participants, officials, employees, promoters, instructors, or others who are responsible for the activities in the school for any damages or injury to my person or property.
Electronic Signature: By entering my name below, I accept the above conditions and releases. (You must be 18 years old or over to sign below.)*

First NameLast Name
Relationship to registered Student:*
Current Date:*

MonthDayYear
There is a $50.00 deposit required to hold spot in camp. There are only 10 spots availbile!

Upon completion of filling in all areas of form, click "Submit Form". You will then be taken to PayPal where you will pay and registration process will be completed. Only one camp student may be registered at a time. You may click "Print Form" to print a copy of this form. Do you have questions or need help with online registration? Email Scoob at mxscoob@@gmail.com.
Click The My Products DSMX Training School Deposit Below To Make Deposit
My Products
prevnext( X )
DSMX Coaching Deposit$50.00
Should be Empty:

Lets Moto

Dirt Soldiers Mx Training School Registration

Liability

Click The My Products DSMX Training School Deposit Below To Make Deposit