Name *

Date of Birth *

Driver's License *

State *

D/L Expiry Date *

Mobile *

Other Phone Number (Home/Office)

Current Home Address *

City *

State *

Postal Code

Email *

Motorcycle Endorsement

Motorcycle Year

Motorcycle Make

Motorcycle Model

Insurance Company

Policy Number

Name *

Relationship

Phone *

Email

Address

City

State

Postal Code

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)

(Choose 1) *

*One Time Initiation Fees of $200: For Club Members only: includes club patch which is the SOLE property of the Sikh Motorcycle Club. **Annual Renewal Fees: $100 over age 25 and $35 for Student Members. *Initial below to acknowledge the terms of the Full Membership _______ *

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)

DATE OF APPLICATION *