Registration Form

District 5 / Deschutes

Starts:

Saturday, April 27, 2024

Location:

East Fort Rock 2510 staging area OMRA YSEP
Road 2510 Staging Area
Bend, Hwy 20 East about 20 mi., OR 97707

Price:

In State: $20.00/youth
Out of State: $75.00/youth

Contact:

Dan Jordan

Phone: 503-913-0528
Email: youtheducation@omraoffroad.com

4-27 Motorycle and ATV Evaluaiton

Youth Off-Road Evaluation for ATV's and Motorcycles Saturday, 10:00AM start. Bring the youth's ATV and or Motorcycle and appropriate riding gear.

Oregon residents $20.00 Out of state residents $75.00

Kids must have completed the online test ( http://www.rideatvoregon.org/ ) and register here with their child's 11-digit Safety Ed number from the online test.

Location 2510 staging area At East fort Rock

For question contact Dan Jordan 503-913-0528

Parent's Information

Parents

Please enter your contact information so we can reach you.

Make sure you use your most current email address so we can email you a copy of your registration and a receipt of payment.

Phone numbers are required so we may contact you via phone.

Parent's First Name

Parent's Last Name

Day Phone

Evening Phone

Email
Email is required for registration confirmation.

Mailing Address

Address

City

State

Zip Code

Physical Address

Address

City

State

Zip Code

Youth #1

Youth Information

All youth information is required to process your registration.

Please double check to see you have entered accurate information for this youth.

Registration Type Class 1 (ATV) Class 3 (Motorcycle)

First Name

Last Name

OASE # Oregon ATV Safety Education Card Number

Date of Birth

(mm/dd/yyyy)

Add Youth

Need to register more than one youth?

Miscellaneous

I would like to receive more OHV Action information.

Billing Information

The billing information you provide here must match the billing information on the credit card you're planning to use below.

First Name

Last Name

Address

City

State

Zip Code

Phone

Promo Code

Code

Payment Information

We accept

Card Type

Number

Code

Expiration / Enter in the format: mm/yy

Order Information

Subtotal

1 @ 20/youth

Total

$0.00

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