X-Country Course

Online Booking & Payment Form

IMPORTANT PLEASE READ BEFORE COMPLETING FORM:

Only complete this form once you have checked and booked the date by phone or text with Jan Lawrie on 0402 760 860.
Please complete a separate form for every rider who will be on the course.
A form needs to be completed by every rider, every time they use the course.
This online booking form replaces the paper form that was previously used.

"*" indicates required fields

Booking Information

Please complete a separate form for every single rider that attends the course.

What is the date you have requested to use the course on?*

Have you checked with Jan that the course is available on this date and been given the okay from her that your booking is confirmed? If not, do that before completing this form please.

What is your estimated start time?*

:

Will you be the only rider on the course or is this part of a group booking?*

I'm the only rider attending the course

I'm part of a group attending the course

I'm the coach/group organiser

Name of person or coach coordinating the group booking

Contact Information

Rider Name

First Last

Rider Age

18 years or older

Less than 18 years old

Mobile Number*

Email Address*

Pay online

Direct deposit is no longer an option, all XC hire fees are to be paid by card on this form

Rider hire fee*

Price:

Clinic booking fee (payable by clinic organiser or coach)*

For groups of 6 riders or more riders. Amount will be advised by Jan at the time of enquiry.

Total

Disclaimer

CAPTCHA

Name

This field is for validation purposes and should be left unchanged.