2009 Rider Skills Days
Please Complete in Clear Block Capitals
Date Requested (please circle) 23rd April 14th July
In the event that your chosen date
is full, we will contact you
e-Mail Address _________________________________________________
First Name ___________________Surname ________________________
Address 1 ___________________________________________________
Address 2 ___________________________________________________
Town/County ________________________ /__________________________
Post Code _______________________ DoB________________________
Tel – Home/Mobile ____________________ /_________________________
IAM Membership # _________________ IAM Group___________________
IAM Status (please circle) Associate Full Member Observer
Any Previous similar training (please circle) Yes No
Where/When _____________________ / _______________________
Preferred Session (please circle) Morning Afternoon
We will make every effort to accommodate your request – if you cannot have your choice will you swap (please circle)
Yes No
Your Bike _____________________________________________________
What are you looking to improve on the day (please circle)
Cornering Steering Braking Observations
Other ________________________________________________________
Next of Kin ___________________________________________________
Contact Number for NoK __________________________________________
I accept and understand that during this event whilst advice may be offered I am in control of my own machine at all times and that I must abide by the rules set out for the event by IAM and Mallory Park Staff
Signature ____________________________ Date ___________________