SMC MEMBERSHIP APPLICATION
Email address *
APPLICANT INFORMATION
Name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Driver's License
Your answer
State
Your answer
D/L Expiry Date
MM
/
DD
/
YYYY
Mobile
Your answer
Motorcycle Endorsement
Phone
Your answer
Insurance Company
Your answer
Policy Number
Your answer
Other Contact
Your answer
Email
Your answer
Current Address
Your answer
City
Your answer
State
Your answer
Postal Code
Your answer
Motorcycle Make
Your answer
Motorcycle Model
Your answer
Motorcycle Year
Your answer
EMERGENCY CONTACT
Name
Your answer
Relationship
Your answer
Phone
Your answer
Email
Your answer
Address
Your answer
City
Your answer
State
Your answer
Postal Code
Your answer
General Vows/ Commitment to Sikh Motorcycle Club, (a California Non-Profit)
1. Do you authorize SMC to share and publish your Photographs, Audio and Video, in our newsletter, website, social media, televised publications and/or directory?
2. Do you agree to abide by the Rules and Regulations of the Sikh Motorcycle Club?
3. Do you agree to abide by the Policies and Procedures of the Sikh Motorcycle Club?
4. Do you agree to support the Mission and Vision of the Sikh Motorcycle Club?
Your Interests and/or Skills (check your choices)
MEMBERSHIP LEVELS
One Time Initiation Fees: For Club Members only: includes club patch which is the SOLE property of the Sikh Motorcycle Club. *Initial_______ **Annual Club Membership Fees: $100 one payment or $10 per month recurring fees.
Your answer
Membership Level
AUTHORIZATION
I authorize Sikh Motorcycle Club to conduct a safety check at any time during my membership with the club. I understand that none of the trips or other activities organized by the Sikh Motorcycle Club is covered by any insurance. The club has no responsibility for the craft or its driver. I authorize the verification of the information provided on this form by the administration of Sikh Motorcycle Club.
NAME OF APPLICANT (SIGN)
Your answer
DATE OF APPLICATION
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google.