New Member ____ Full Membership _____
One application per person. Renewal _____ Associate Membership _____
Name __________________________________________E-Mail ___________________
Street Address ___________________________________________________________
City__________________________State_________________________Zip____________
Telephone - Home __________________Work or Cell ____________________________
Birthdate __________________________Anniversary_____________________________
Occupation & Place of Employment ___________________________________________
Motorcycles You Presently Owm (Make, Model, Year)______________________________
_______________________________________________________________________
No. of Miles Ridden Last Year _____________No. Years Riding ___________________
Are you an AMA Member? ________________AMA No. ___________________________
Have you taken an MSF Course? _________________________
Your favorite ride _________________________________________________________
PLEASE READ AND SIGN THIS WAIVER
I understand that motorcycle riding can be dangerous and agree that neither Mid-Michigan Riders nor any of it's Officers or Members will be held responsible for accident, injury or loss, in connection with Club activities including travel periods to and from those activities. I also agree and understand that there will be no drinking of alcoholic beverages during club activities.
Signature _____________________________________Date ______________________
MMR Annual Waiver
Please Print the above waiver and sign it with your application
MMR Minor Release Waiver
Please print and sign the above waiver if you have a minor with you. |