First Name*:   Middle Initial:    Last Name*:

Address Line 1*: 

City*:    State*:    Zip Code*:

Day Phone*:    Evening Phone:

eMail Address*:   

Age*: Select Age 16-17 18-20 Over 21

Choose a class.  Please provide a 1st and 2nd choice.  If you are only available for one specific class date, then select the same class for your 1st and 2nd choice.  You can see a list of available classes on the SCHEDULE link.

1st Choice*:  Select 1st Choice Class B23MXB BOSTON 05/28/2012 Mon noon-6PM F29SatXB Foxboro 07/14/2012 Sat 1PM-7PM B37MXA BOSTON 09/03/2012 Mon 7AM-1PM    2nd Choice*: Select 2nd Choice Class B23MXB BOSTON 05/28/2012 Mon noon-6PM F29SatXB Foxboro 07/14/2012 Sat 1PM-7PM B37MXA BOSTON 09/03/2012 Mon 7AM-1PM

Notes (where did you hear about Streetwise Cycle School?):

If you are redeeming a Gift Certificate for full or partial payment, enter the Certificate Number below:

Gift Certificate Number:

  Check here if you have a leg in-seam less than 26 inches.

  Check here if you have a hearing, reading, or other type of DISABILITY.

  Check here if you have a primary language other than English.

If you checked any of the above items, please call the office at (781) 974-2474 prior to registering to discuss if we can accommodate your special needs.

Read the Terms, Course Descriptions, and Course Requirements and click on the "Yes, I ACCEPT" box below.

No Yes I ACCEPT the Terms, Course Descriptions, and Course Requirements outlined above?*

You must accept the Terms, Course Descriptions, and Course Requirements in order to register.