Provide a list of any PRESCRIPTION medications you take or any acute or chronic medical conditions that you have. This information will be given to medical personnel in the event of a medical emergency. Enter "NONE" if this does not apply to you.
Provide a list of dietary restrictions or other needs you have. Please include such things as allergies, vegetarian nutritional restrictions, and intolerances (i.e., lactose intolerance).
Please read carefully and confirm with your initials that you agree with all of the statements where 0 to 4 characters are required to be entered. This signifies your understanding and compliance with each item.
I certify that I meet the physical & mental requirements to participate. I will come to DIRTYforGOOD rested and ready to learn. I will bring my license with a motorcycle endorsement to the DIRTYforGOOD Rider Training Tour.
I CERTIFY that I will secure repatriation insurance to cover the return of myself and my motorcycle should this become necessary. The organizers have carried such insurance year-round since 2010 and have never needed to use it. This type of insurance provides peace of mind when traveling in remote areas. Crisis intervention, rescue, and helicopter rides are not cheap. You can opt for a short term policy if desired.
I will come to the DIRTY FOR GOOD Off-Road Riding Camp with proper riding gear: DOT-approved full-face, modular or dual sport/dirt riding helmet; eye protection (goggles or face shield); chest/back protection; elbow/shoulder protection; full-fingered gloves; dirt/dual sport/adventure boots; and a hydration system.
NOTE: Armored, motorcycle-specific road gear is NOT acceptable unless it is adventure riding gear. For Dirt/Dual sport/Adventure specific riding gear, consider going to revzilla.com or cyclegear.com and look at their offerings. We can provide you with other online resources if needed.
I understand that I will pay the registration fee of $1,200. A $400 non-refundable (but transferrable) deposit is required to hold one's spot. These registration fees also include lodging two (2) riders per room or camping, ride guides, situational trail riding instruction, t-shirt, retroreflective tour stickers, drayage for luggage (and sleeping bag), breakfast, healthy snacks for the trail (which will be self-packed each day). These fees cover August 22, 2021, through the morning of August 27, 2021.
My final payment must be made by August 1, 2021.
Once we receive your registration, you will receive an invoice for $1200.
As with DIRTYforGOOD 2020, postponed due to COVID-19, should for any reason DIRTYforGOOD 2021, be canceled, all deposits and payments will be refunded.
I understand that Opening and Closing Tour Dinners are provided. However, I am responsible for paying for all of my lunches and other dinners. As some of the evening dinners will be delivered to our nightly lodging sites, I will bring cash + 15% gratuity to cover those delivered dinners.
I understand that the North East Backcountry Discover Route is not intended for beginner riders. Successfully riding this route requires a minimum of INTERMEDIATE SKILLS and successful completion of at least one formal off-road rider training course.
I understand that dual sport/adventure motorcycle riding involves inherent risk. I accept this risk and hold harmless all organizations, lodging/camping sites, restaurants, ride guides, instructors, volunteer staff, and locations along the way. None of these entities are responsible for my PERSONAL SAFETY.
List the minimum 2-day Dual Sport/Adventure Motorcycle Pre-Tour Training you will be taking during the 2021 riding season.
NOTE: SheADV will be providing a 2-Day Training for women at Touratech's DirtDaze event on August 18-19, 2021.
Please note this below in order to receive registration materials.
List your Dirt/Dual Sport/Adventure Riding Experiences you have had in the past three (3) years.
I agree to bring a street-legal, mechanically sound Dual Sport or Adventure bike to DIRTYforGOOD. It can be one that I own, borrow or rent. A 250cc – 400cc, light-weight dual-sport model is recommended. The motorcycle should be equipped with handguards, a skid plate, and depending on the
model, engine guards. The motorcycle should be able to operate for at least 100 miles on one gas tank fill, or you will be required to bring an auxiliary container for carrying added gas. The motorcycle should be fitted with DOT knobby tires with at least 90% of the tread remaining rated at least 50% dirt, and 50% road will provide the best ride for our conditions. We advise that you use HEAVY DUTY tire tubes if running with tubed tires. You must provide current registration or rental paperwork for the model you bring to the DIRTYforGOOD site.
If you know what bike you will be using, please list it below by giving MAKE, MODEL, and ENGINE SIZE. If you do not know what bike you will be using, enter "DO NOT KNOW".
I understand and agree, in addition to my registration fee, I MUST raise or self-pay a minimum of $250.00 for WMF's chosen 501(c)(3) charitable organization.
Final Salute, Inc.: a Female Veteran's organization to provide housing for Female Veterans.
I understand that WMF, Inc. will not use these funds raised by the riders for its overhead or operating expenses.
I agree to not mix any substances that would interfere with my judgment, vision, physical or mental condition including but not limited to alcohol, over-the-counter or prescription drugs with the riding experience.
I agree to bring any of my concerns, especially concerns revolving around safety, immediately to the instructors or the DIRTYforGOOD
organizers Gin Shear, Sue Slate and Shalmarie Wilson.
I understand that, as long as this registration form is, it will be reviewed again and signed again during orientation in North Haverhill, NH, no later than August 22, 2021.
I understand and agree with the use of my image, as shown below. The choices checked in the list below are items that have my consent.
By entering your full name below, you are asserting that you have provided accurate information and have read, understand and agree to meet and accept all requirements for participation.
DURING CHECK-IN AND ORIENTATION YOU WILL BE ASKED TO REVIEW AND SIGN THIS DOCUMENT AGAIN ALONG
WITH READING AND SIGNING OTHER WAIVERS OF INDEMNIFICATION.
This field is for validation purposes and should be left unchanged.