Killer Creek University Killer Creek University MSF Basic Rider Course Registration Form The cost of the course is $320 per student When you Submit this form you will be redirected to our online store for payment.
Course Date *	February 22nd - 24th, 2019   March 29th - 31st, 2019   April 26th - 28th, 2019   May 24th - 26th, 2019   June 28th - 30th, 2019   July 26th - 28th, 2019   August 23rd - 25th, 2019   September 27th - 29th, 2019   October 25th - 27th, 2019   November 29th - December 1st, 2019
First Name *
Last Name *
Street Address *
City *
State *
Zip *
Phone Number *	### - ### - ####
Alternate Phone Number	### - ### - ####
Email Address *
Drivers License # *
Drivers License State *
Drivers License Class
Gender *	Male   Female
Date of Birth (mm/dd/year) Student must be 17 within 90 days of course completion. *
Do you currently own a motorcycle? *	Yes   No
Do you understand our Refund Policy? *	Yes, have read and completely understand the refund policy in place.
Are you current or retired Military or a First Responder?	Yes   No
How did you hear about the KCHD-U Basic Rider Course? *	KillerCreekHarley.com   Third Party Event Calendar   Friend/Family Member   Facebook   Other
If "Other" where did you hear of the class?