VISC Course Registration Form

Each participant is required to complete a separate registration form.

To aid in your course selection process, please review our
Course Schedule for course availability, preferences and dates.

(Course Schedule will open in a new browser window)

Check our Course Schedule

STUDENT INFORMATION

First Name

Given/legal first name as it appears on your identification/license

Last Name

Surname as it appears on your identification/license

Preferred Name

Name you wish to be referred to by if different than you legal name.

Date of Birth

YYYY

Gender/Pronouns

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Contact Phone Number

Number we can best contact you - typically your cell number

(###)

###

####

Alternate Phone Number

Home or work number

(###)

###

####

Drivers License Number

Drivers License Class(s)

Expiry Date

Drivers License expiry

YYYY

Motorcycle Learners License Expiry Date

If you do not yet have your class 6L or 8L motorcycle learners license please leave blank.

YYYY

Years of Driving Experience

Years of Motorcycle Riding Experience

How did you hear about VISC?

COURSE SELECTION

Select Novice Course

Courses are available select Weekdays and Weekends. A $100 discount will be applied to final invoicing if you select and register for both Novice and Traffic Skills Courses together!

Select Course Preference

AM courses have riding in the morning & classroom in the afternoon PM courses have classroom in the morning & riding in the afternoon

Select Novice Course Dates

Select the course number and dates you would like to register for WE = Weekend, WD = Weekday Leave BLANK if you are not selecting a Novice course.

Select Traffic Course

You may choose to add a Traffic Skills Course now or you can always add on at a later date. NOTE: Completing Novice Skills Course is a prerequisite for taking this course! Select "No Traffic Skills Course" if you do not want to register for a Traffic course.

Select Traffic Course Dates

Select the course number and dates you would like to register for. Traffic course date must be AFTER completion of your Novice course dates! WE = Weekend, WD = Weekday Leave BLANK if you are not selecting a Traffic Skills Course.

Other Courses

You can select from additional VISC courses such as Experienced Rider's Course (ERC) or Rider Refresher Training (RRT). Leave BLANK if you do not want to register for other courses.

PAYMENT

Full payment is required prior to the start of your course and will secure your course registration.

Payment Method

Select your method of payment. For added security our web site is SSL secured and payments are processed manually at our office and not online. Once your course(s) have been confirmed and payment processed, your credit card information is deleted from our system.

Credit Card Number

A surcharge of 3% will apply to all credit card payments.

Credit Card Expiry

Do not use "-" or "/"

MEDICAL & HEALTH INFORMATION

Please indicate if you suffer from the following ailments

List any conditions, injuries, physical impairments or medications that could possibly affect your ability to operate a motorcycle

Emergency Contact Details

First Name

Last Name

Relationship to Student

Emergency Contact Phone

(###)

###

####

Additional Information

Use this field to relay any additional information or requests in relation to your selected course(s). (E.g. You would like to be in the same class as another registered individual such as a co-worker or friend).

TRAINING AGREEMENT

I hereby apply for motorcycle training conducted by the Vancouver Island Safety Council, and hereby promise to pay the tuition fee in full prior to the start of training. I understand and accept the condition that attendance at all training sessions is mandatory and that no refund of tuition will be made for missed sessions. I also realize that extra fees will be charged for missed sessions, extra training or any make-up training that I may require. I also confirm that I have disclosed all relevant medical information as required on this application form and promise to advise my instructors of any change in my physical condition that could affect my training.

I agree to the Training Agreement

Initials

WAIVER OF LIABILITY

All students registered in a Vancouver Island Safety Council (VISC) rider training course must confirm that you have read, understand and agree to be bound by the VISC's Training Risks & Liability Waiver. VISC takes every precaution to minimize the risk of accidents occurring during training and we have an excellent safety record to prove this. There is always an element of risk present in learning to operate a motorcycle. VISC accepts the risk of damage to our training equipment and students will not be required to bear the cost of any accidental damage to our equipment. VISC cannot accept responsibility for any bodily injury or damage to student's property while they are participating in our courses. All students and the parents/guardians of minors, will be required to sign a release of liability electronically for such bodily injury or property damage BEFORE commencing training with VISC.

I agree to the Waiver of Liability

Initials

CANCELLATION & TRANSFER POLICY

All students registered in a VISC rider training course must confirm that you have read, understand and agree to be bound by the VISC's Cancellation & Transfer Policy. When you register for a course, you are paying for and taking up one 'place' in the course. Unfortunately, once training has started, we cannot substitute or fill 'your place' with another student and refunds will not be issued.

I agree to the Cancellation & Transfer Policy

Initials

EXTRA TRAINING INFORMATION

Students are required to achieve a passing grade to complete the Novice Skills Course and some may require Extra Training sessions in order to achieve a passing grade. Students must safety and adequately demonstrate one riding skill set before advancing onto the next, as well as achieve a minimum level of “Acceptable” in all areas of course riding to successfully complete/pass the Novice Skills Course. Students are expected to keep pace with their course’s dates and timeline in order to continue and progress with their originally registered course. Extra Training sessions are at the student's expense and are not included as part of the Novice Skills Course. Extra Training sessions will be required for those students who are: • Not demonstrating safe riding • Posing a danger to themselves or others • Riding skills are not at minimum level of “Acceptable” • Riding exercises are marked “Incomplete” or “Needs Improvement” If a student cannot, or choses not to attend Extra Training session(s) to correct riding deficiencies identified by their Novice Skills Course instructor(s), they will: • Not be allowed to continue with their Novice Skills Course • Not be transferred into a different Novice Skills Courses (student can re-register for a new course) • Their Novice Skills Course training will end at this point

I have read and understand the Extra Training Policy

Initials

VISC Course Registration Form

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VISC - where the ISLAND Learns to Ride!