Please print the application, then mail or fax to:
Rolling Wheels Training Center, LLC FAX: 816-478-3677
4804B Noland Rd.
Kansas City, MO 64133
OR – call 816-478-3677 for information
On-line registration is not available for this class. However, applications will be accepted by phone.
Students are registered on a first come / first serve prepaid basis.
A 100% refund, less a $25.00 processing fee, will be issued if the registrant cancels the class MORE than 7 days in advance. Refunds are not available if the registrant cancels less than 7 days prior to the opening of the class. If the instructor determines the student is not eligible to complete the class or if the student voluntarily decides to leave the class, refunds are not available.
There will be a $10.00 fee for re-scheduling your class. You must reschedule your class more than 7 days in advance.
A list of items to bring to class as well as wearing apparel information will be sent with your confirmation letter.
Classes fill quickly. EARLY REGISTRATION IS SUGGESTED.
Name Date of Birth
If training with your passenger,
Passenger Name Date of Birth
Business Phone Home Phone
Address
City, State & Zip
**If under the age of 18: Parent’s Signature
Experienced course is $100.00 per rider. Add $30 for your passenger to train together. Total :
Class date: ____________________
Method of payment: Check Make Checks payable to: Rolling Wheels Training Center, LLC
Master Card Visa Discover ________ American Express
Card Number Expiration Date
Name as it appears on the card, if different from above
Total Amount: ________________
The issuer of the card identified on this item is authorized to pay the amount shown as Total. I promise to pay such Total subject to and in accordance with the agreement governing the use of such card.
Signature & Date ______________________________________________