MEMBERSHIP
APPLICATION
For Club Use Only
Accepted: _______
Induction Date:__________
Type Membership: LT RM AM
Membership # __________
Welcome! Please use this form to make application for membership to
the OKC Freedom Riders Motorcycle Club. You can mail this form to OKC
Freedom Riders, PO BOX 57363, Oklahoma City, Ok. 73157-7636 or bring
it with you to our next club meeting. Visit our web site at
www.okcfreedomriders.com
________________
Date of Application
___________________
Last Name
_________________
First Name
_______________
Road Name
__________________________________________________________________________
Street Address
City
ST
Zip
_______________ ______________ _____________ _____________________________
Home Phone
Cell Phone
Work Phone
E-Mail Address
___________________________________ _____________
Your Bike Info (Yr., Make, Model)
Color
Emergency Contact Name:___________________ Phone #___________
Number of years riding experience: ___________ Passenger/Driver (circle one)
Member Acknowledges the fact that operating a motorcycle in any situation is dangerous to
life and limb and property, and agrees to hold harmless the club, all club officers, club
members, and club sponsors past and present, from any liability for loss of life or harm or
injury to body or the damage or loss of personal property. Member acknowledges full
responsibility for his or her guest, including any actions, events and consequences arising
from such person’s participation in club events and that of their own. In addition, I have
read the “Wearing of Colors” declaration and understand that the colors belong exclusively
to the OKC Freedom Riders, and sole property of the club.
______________________________________
Signature
___________________
Date