John Coach Cycling Academy™
Registration form for joining - John Coach Cycling Academy™
Email address *
Full name *
Your answer
Short name / cyclist id number *
Your answer
District
Your answer
DoB/Age *
Your answer
Gender *
Working / Not working / Studying at *
Your answer
Phone number *
Your answer
Emergency Phone number *
Your answer
Blood group *
Your answer
Parents/Guardians Consent Mandatory for below 18 years age. *
Parents Full Name *
Your answer
Parents/Contact person Mobile number *
Your answer
Read/heard,understood and agree the disclaimer published in website (http://www.johncoach.com/disclaimer/) or (http://www.eaincogroup.com/disclaimer-2/) ________________________________________________ - Note: johncoach & eaincogroup are our official website.Both the disclaimer/waiver forms are same. *
Cycles you have *
Your answer
Your present Address *
Your answer
Add me to John coach cycling *
Required
Photographs/video clips of all members shall be featured on our public website, and sent to mainstream media.However,We will also publish names of all members on our website and maybe in media releases.I am willing to be ambassador of JOHN COACH™ *
Which State you belong and what outcome you expect by joining - John coach cycling academy™ *
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Remarks
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