Waterford Precision Cycles

Rider Registration

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Rider Registration Form

Order #:
Serial #:
Model:

Dealer/Seller Name:
Dealer Contact:
Dealer/Seller City:
Dealer/Reseller State:

Name:
Email:
Confirm Email:
Password:	(Allows you to change information later)
Confirm Password:
Address:
City:
State:
Zip/Postal Code:
Phone:
Fax:

Owner's Age:
Occupation: (Check all that apply)	Retired Proprietor Housewife Student Professional/Technical Administrative Support/Clerical Manager/Administrator Craft/Precision Production
Annual Income:

How long have you been a serious cyclist?
What kind of rider are you?	Recreational Commuter Road Racer Off-Road Racer Triathlete Track Touring/Trekking Other
How many miles do you ride per year?
Name/address/phone of your local bike club/team:
Do you belong to:	NORBA USCF IMBA LAW Rails-to-Trails Adventure Cycling Assoc.
Names of magazines you read:

How did you hear about Waterford?	Recommendation Yellow Pages Advertising Your Bike Shop Previous Bike Another Waterford Owner Other
Do you participate in the following other sports?	Skiing Hiking Swimming Running Tennis Roller-skating/Blading Volleyball Surfing Other
What brands/models of bikes do you already own:
What kind of bicycles do you own?	Recreational Commuter Road Racer Off-Road Racer Triathlete Track Touring/Trekking Other
How would you rate your overall satisfaction with your new Waterford Frameset?	Outstanding Good Fair Poor
How would you rate your overall satisfaction with your Waterford Dealer?	Outstanding Good Fair Poor
Comments:

Would you like to join Waterford's Mailing list?	Yes No

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