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Bikefarm Membership Signup!
This form is for new and renewing membership sign-ups.

Membership suggested donations: $20/mo | $35 for 6mo | $60 year | $200 Lifetime

Name *
Your answer
Choose any member number (4 digits)
(you can ignore this now)
Your answer
6 month *
Membership suggested donations: $20/mo | $35 for 6mo | $60 year
Enter Expiration Date (starting from today) *
number format: MM-DD-YY (e.g. 03-24-2013 - March 24th 2013)
Your answer
Email Address (optional)
We will never spam, sell or give away your email address. Used for membership info, volunteer and events contact only.
Your answer
Phone Number (optional)
We will never spam, sell or give away your phone number. Used for membership info only.
Your answer
By having a membership with Bike Farm, you agree to participate in our Safer Space Agreement *
Bike Farm is a cooperative space that is accepting and inclusive of every race, economic class, religion, nationality, sexual orientation, gender identity, age, ability, et cetera.
Initial Below if You Agree to the Bike Farm Liability Waiver *
I, and my heirs, in consideration of my participation in Bike Farm Inc., hereby release Bike Farm Inc., its officers, employees and agents, and any other people officially connected with this event, from any and all liability for damage to or loss of personal property, sickness or injury from whatever source, legal entanglements, imprisonment, death, or loss of money, which might occur while participating in this event. Specifically, I release said persons from any liability or responsibility for injury while workign on my bike and other accidents relating to riding this bicycle. I am aware of the risks of participation, which include, but are not limited to, the possibility of sprained muscles and ligaments, broken bones and fatigue. I hereby state that I am in sufficient physical condition to accept a rigorous level of physical activity. I understand that participation in this program is strictly voluntary and I freely chose to participate. I understand that Bike Farm does not provide medical coverage for me. I verify that I will be responsible for any medical costs I incur as a result of my participation.
Your answer
Are you at least 18 years old? *
If under 18 years old, your legal parent or guardian will be needed to fill out this form. Or have them send us a note.
Who should we contact in case of medical emergency? (optional)
Your answer
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