Application to Join The Great Lakes Riding Club
Name:______________________________ Rider_____ passenger______
Address_____________________________________________
City___________________
Zip__________
Phone____________________ Cell Phone___________________
Person to notify in case of emergency __________________________
Email_________________________________
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 belong to any other clubs/chapters? (Please
list)_______________________________________________
Have you held any positions in other clubs, if yes then what?________________
How
did you here about us?______________________________
What are your expectations from joining this riding club? ________________________________________________________________________________________________________________________________________________
***All
information will not be shared or made public knowledge or discussed among members with the exception of the President, Vice President
and Chapter Secretary in accordance with HIPPA laws.
I have Read the Constitution and bylaws and agree to not hold The Great Lakes
Chapter Riding Club liable under any circumstances.
__________________________________ _______________
Sign Date