BMW "Rim"Riders of Arizona

BMW Motorcycle Owners of America [MOA] Chapter #188

Application for Membership

Legibility counts!

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Date:______________

Name:_________________________  MOA membership #________

Address:______________________________________________

City:__________________  State:____         Zip:______

Email: ________________________________Phone:__________

Sponsor:_______________________________

 

I do hereby release the BMW “Rim” Riders of Arizona, as individuals and as an organization of any responsibility for accident or injury during my voluntary participation in their events.

Please enclose your check for $5.00, payable to Angie Brennan.

Signature  __________________________________________________

Bring to Thursday Club meeting or mail to:

Angie Brennan

4246 E. Equestrian Trl.

Phoenix, AZ. 85044

(Office Use:  Date Received ________     Funds Enclosed______         Member # __________)

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