Northern Nevada Confederation of Clubs


All posts are reviewed and subject to phone call confirmation, but the Confederation of Clubs
has no guarantee of the accuracy or timeliness of any information posted here and assumes no
responsibility for any information found here.
 

All posts must be filled out completely. Your Name and Phone Numbers will not be posted,
but are needed assure accuracy of posts. Please do not post rumors, or hype. - enough said...
Webmaster Mike
 

 

 Your Name

 Your Club Affiliation

 Your Phone Number

 Best time to contact you.

 Riders Name

 Riders Nickname / Club Position

 Date of Incident ( The date you fill this out is automatically added to form)

Type of Incident

Description of Incident  - Please describe briefly


Status of Biker

If in hospital - which one? What Room?

Can they receive visitors? Yes    No 

Any Special Needs - Extra Info the COC should now about?