|
Member's Name ______________________________________________Nickname_____________________ Associate's Name _______________________________________________Nickname____________________ Address ___________________________________________________________________________________ ________________________________________________________________ ZIP _______________ Home Phone (_____)______________ Work Phone(s) _(_____)________________/_(_____)_______________ E-Mail address __________________________________________________________________ Member/Associate Occupations _______________________________/______________________________ BMWMOA Member? Yes _____No_____ MOA #'s____________/____________ BMWRA Member? Yes _____No_____ RA #'s____________/____________ BMW Model(s) _____________________________ Year(s) ___________________________Sidecar? ________ Other Clubs, Hobbies, Interests: _________________________________________________________________ ___________________________________________________________________________________________ In case of EMERGENCY, notify: ________________________________________________________________ Address: ________________________________________________________________ Phone: (_____)_______________ ____________________________ZIP_______________ Release to BMWMCHR: I, the undersigned, hereby agree to abide by the club by-laws, and do relieve the BMWMCHR from any liability for personal property damage, theft, bodily injury, or motor vehicle accident that might occur as the result of my participation in club events or my membership in the club. Member ___________________________________________________Date_____________ Associate Member ___________________________________________Date_____________ Dues: $20.00 per year. After July 1, $10 for the remainder of that calendar year. $5.00 per year for Associate Membership. $10.00 per year for Corresponding Membership if you live out of townť, but still wish to be a member Mail/Deliver. Application & Dues (check payable to "BMWMCHR") to: Rusty Barton 3205 Twinflower Lane Virginia Beach, VA 23453 757-427-0315Club Information The BMW Motorcycle Club of Hampton Roads is a close-knit group of BMW riders and their families from throughout the Tidewater area. Our member's backgrounds are as diverse as their riding styles, from peg-draggers to sedate touring bikes. We welcome all riding styles and all BMW models vintage airheads through the latest in oilheads and K-tech. E-Mail the Webmaster at webmaster@bmwmchr.org or click here to use our on-line form. | |||||
|
|
|