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Crash Poll

Just stay calm and try to remember as much as you can...
This is very un-official, non-incriminating and I promise
not to share any information with your insurance agent.
Heh, heh, heh...

Your Email Address (if you want):

The Season when you crashed:

Make of Motorcycle:

Model or Size in cc's:

Model Year:

Your age at crash:

Were you wearing a Helmet?:

On Road or Dirt?:

Under the Influence of any Alcohol or Drugs?:

Were you seriously injured?:

Were you riding two up?:

Were you riding with a group?:

Was your bike loaded with gear?:

In your own words:

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