Please fill out and submit information listed below.

Parent/Guardian Name:
	First	Last
Phone:	( ) -
E-mail:
City:
	Note: Hands-on Courses can only be requested for locations within Oregon. We also make every attempt to provide courses locally but typical travel-time is one to two hours from your home town.

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Youth Name:
	First	Last
Youth Age:
Youth ATV Safety Education Card #:
Safety Education Card Number is required prior to taking a Hands-on course. To obtain a card number, please complete the online safety course. Click here to get started
Operating Experience:		Select Some Experience No Experience
Indicate Vehicle Class:		Select Class I (Quad) Class III (Off-Road Motorcycle) Class IV (Side x Side)

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Comments:
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