Repented Motorcycle Ministry Application
Thank you for your interest in Repented M/M. Please answer all the questions and a Repented Patch Holder will contact you within the next week.
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Email *
Your Brothers are waiting!
Today’s Date *
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FULL Address With City/State/Zip/Country *
Cell Phone Number *
Legal Name (First, Middle, Last)
Emergency Contact, Relationship, and Contact Number *
How did you hear about us? *
Do you have any MC or Riding Club experience? Please explain. *
Your Facebook Account Name
What church do you attend? (include city and state) *
What type of ministries are you currently involved in? *
What type of Motorcycle do you have and how many CC's? *
Do you own it? *
Occupation *
How long have you been riding? *
Are you associated with Law Enforcement? (We minister to Outlaws) *
Do you understand and agree that Repented Motorcycle Ministry and our affiliates are not responsible for any injuries you may incur while riding with Repented M/M? *
Do you understand and agree that all member gear and our logo is property of Repented M/M and shall be returned in the event of departure? *
Would you please consider making a donation to repentedmm.org when you finish this application to support our ministry? *
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