ROSE CITY MOTORCYCLE CLUB

Membership Application


        Membership Type: Full/New  Full/Renewal  Junior/New  Junior/Renewal

        Name:

        Spouse or S.O.:

        Address:

        City: State: Zip:

        AMA #:*Optional          Expires:          Date of Birth:

        Home Phone:                   Work Phone:                 Cell Phone:

        Email : 

        Sex:    Male  Female          T-Shirt Size:


MOTORCYCLE INFORMATION

        Make/Model:  Yr:  cc:  Current Odometer Mileage:
        List any additional Motorcycles on back of page


WAIVER OF LIABILITY, INDEMNITY AND MEMBERSHIP AGREEMENT

If accepted as a new or renewal member of Rose City Motorcycle Club ("RCMC"), I agree to abide by its by-laws and accept its Board of Directors as its governing body. I agree to be aware of and responsible for my conduct as a RCMC member and as a motorcyclist before the public.

In consideration of and as partial payment for my acceptance as a RCMCmember, I do for myself, my heirs, executors, administrators and assigns, hereby give up, RELEASE and forever DISCHARGE in advance my rights to sue or make any claim for damages due to negligence or carelessness against RCMC and its Officers, Directors and ride leaders for injury to person or property that I may suffer, including crippling injury or death, while participating in RCMC activities, rides and events, whether they are formal or informal.

I AM AWARE THAT MOTORCYCLING CARRIES A SIGNIFICANT RISK OF SERIOUS PERSONAL INJURY, DEATH AND PROPERTY DAMAGE. I know the risks of danger to myself, my minor child (if present), and my property while participating in RCMC activities, rides and events and, relying upon my own judgment and ability, I ASSUME ALL SUCH RISKS OF LOSS, and hereby agree to reimburse all costs to, and to forever HOLD HARMLESS and INDEMNIFY, RCMC and all persons identified above, generally and specifically, from any and all liability for death and/or personal injury or property damage resulting in any way from my participation in RCMC activities, rides or events, whether they are formal or informal.

        Applicant Signature: ___________________________________________________________________ Date: 





After you have filled out the application,  one copy and sign it.


Send Signed Form and $30.00 check
TO:
     RCMC
     New Member
     P.O. Box 56691
     Portland, OR  97238