Application to Join the Great Lakes Riding Club

Print and complete and  mail to:

Great Lakes Riding Club,  17388 Leafdale Ct.,  Macomb,  MI.  48044

 

Name:__________________________________________ Rider______  Passenger______

 

Address___________________________________________________________________

 

City_______________________ Zip__________

 

Phone_____________________ Cell Phone___________________

 

Email__________________________________________________

 

Person to notify in case of emergency (Contact Name and Phone No.)

 

_________________________________________________________________________

 

Make/Model of bike _____________________________________________

 

Do you have a Valid License________ Cycle Endorsement______ Insurance______

 

Years of riding experience _________

 

Do you have any medical conditions? _________________________________________

 

Have you ever been a member of any other clubs or chapters? (Please list)

 

_________________________________________________________________________

 

Have you held any positions in other clubs, if yes then what?_____________________

 

How did you hear about us?_________________________________________________

 

What are your expectations from joining this riding club? _______________________

 

_________________________________________________________________________

***All information will not be shared or made public knowledge or discussed amongst members with the exception of the President, Vice President and Chapter Secretary in accordance with HIPPA laws.

 

I have Read the Constitution and By Laws and agree to not hold The Great Lakes Chapter Riding Club liable under any circumstances.

 

 

__________________________________                      _______________

 Sign                                                                                   Date