SERVICE FORM
Please Send ALL parts to: Mountain Race Shop 2644 Shannons Flat Rd Shannons Flat NSW 2630
*Please remove ALL hardware, guards, guides, etc. before shipping Please take care when shipping wrap in bubble wrap or other protective form before packaging, Mountain Race Shop will not be liable for damage in transit.
Please fill out and send both pages
Rider / Bike Information
Name of Rider: ______
Bike Year ______
Bike Make ______
Bike Model: ______
Suspension Service
Item(s) Sent In: (circle) Forks Shock
Weight w/o Gear ______Kg
Type of Riding (circle) Motocross Supercross Enduro Trail
Ability (circle) Novice Beginner Clubman Intermediate Expert / Pro
Class (circle) C B A
Terrain (circle) Grass Track Natural Man Made
Other Information
What is the bike doing?
Description of Work
What work are you requesting?
Billing Information
Name on Credit Card: ______
Home Phone: Work Phone: ______
Payment Method: (circle one) Visa Master Card
Credit Card Number: ______CCV: ______Exp Date: ______
Shipping Information
Ship to Name: ______
Address: ______
Town: ______
State: ______
Postal Code: ______
Email: ______
Phone: ______
Shipping: (circle one) Australia Post Ground Freight Overnight
· Note if you have a freight account you want us to use list the details here
Name: ______
Account number: ______
Freight Company ______
Order Number or Authority: ______
I (enter your name)______authorise Mountain Race shop to provide Suspension Modification services and charge my Credit Card (if applicable) and accept that the information I have provided is truthful and will be used to make assessments as to the modifications required. The final modifications will be based solely on the information I have provided.
Sign here ______
Fenian Park Pty Ltd, ABN 66 112 280 172, Lic 208797C
2644 Shannons Flat Road Shannons Flat NSW 2630
Canberra 02 6242 0175 Cooma 02 6454 5173 Mob 0420 947 505