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  • Application for MC Club
    Updated On: Jan 31, 2014

    IBEW LU 503 MOTORCYCLE RIDING CLUB APPLICATION

    3 RIeger Dr. Monroe, NY 10950 845-783-5007

    www.ibew503.org


    All Prospective members shall first be proposed by a member in good standing and must attend one (1) meeting prior to membership. There shall be no prospects.
    If voted into Club, the 1st year’s dues are due at this meeting.  Annual dues shall be $40.00. The complete patch set shall be $100.00 $_____________Check #: _______
    Name: ________________________________________________Nickname:_____________
    Address: ______________________________________________City:__________________
    State: _______ Zip: __________ Emai Address:___________________________________
    Phone/Home: _________________________Cell:____________________
    Date of Birth: _______________ Motorcycle Type: __________________ Year: ________
    Emergency Contact: Name: _______________________________ Phone:_____________
     

    Are you a member or have you ever been a member of another motorcycle club? ( ) yes ( ) no
    If answer is yes, name of Club? _______________________________ Date/s:_________

    I give written permission for the IBEW Local 503 Riding Club to have my name and address and cell phone number on their website for mailing purposes and notifications. 
    I certify that all information provided on this application is true. I further understand that any false information could lead to my membership being terminated.

    Sign Here___________________________________________Date:__________________


     

    Membership Qualifications:

    1. Be at least eighteen (18) years of age
    2. Ride a minimum of 50% of club sponsored rides
    3. Attend three (3) club meetings
    4. Copy of valid motorcycle license endorsement
    5. Copy of current insurance card
    6. Must be sponsored by a club member
    7. Must receive a positive vote of 75% of club members present at meeting
    8. Dues must be paid.

    For Staff Use Only:

    Membership Date: _______________________________________
    Dues Paid ( ) Date: _______________________________________ 
    Waiver Signed ( ) Date: ___________________________________
    By-Laws ( ) Date: ________________________________________
    Valid Motorcycle License ( ) Date: __________________________
    Current Insurance card ( ) Date: ____________________________


     

                                         IBEW LU 503 Motorcycle Riding Club Waiver/Agreement

    The undersigned, (on my own behalf and on behalf of my heirs, personal representatives, successors and assigns), for and in consideration of the opportunity to participate in a “Ride”, “Poker Run’, “Rally”, “Field Event”, “Bike Show”, or “Activity” (hereafter known as EVENT(S) do hereby agree to indemnify and hold harmless the IBEW Local 503 MOTORCYCLE RIDING CLUB Inc., their officers, employees, agents, volunteers, and sponsors (hereinafter, the “RELEASED PARTIES”) from and against claims, actions, suits, losses, damages, and liabilities, including attorney fees and cost of defense, arising from any contention or allegation, whether well founded or otherwise, based on any acts of conduct by said parties, which are reasonably necessary to effectuate the purpose of said activity and/or events.


         I, FULLY UNDERSTAND THAT THIS MEANS THAT I AGREE NOT TO SUE ANY

    OR ALL OF THE “RELEASED PARTIES” FOR ANY INJURY RESULTING TO MYSELF

    OR MY PROPERTY ARISING FROM, OR IN CONNECTION WITH THE PERFORMANCE

    OF THEIR DUTIES IN SPONSORING, PLANNING OR CONDUCTION THE EVENTS.


    Furthermore, I certify that I am experienced in and familiar with the operation of motorcycles and fully understand the risks and dangers inherent in motorcycling. I am voluntarily participating in the EVENTS(S) and I expressly agree to assume the entire risk of any accidents or personal injury, including death, which I might sustain to my person and property as a result of my participation in the EVENT(S) and any negligence (except willful neglect) on the part of any or all of the “RELEASED PARTIES” in performing their duties.


    I further agree to waive all benefits flowing from any state statute, which would negate or limit the scope of this release and Indemnification Agreement.
    By signing this Release, I certify that I have read this Release and fully understand it.
     

    NOTE: If Under 18 Years of Age, Signature of Parent or Guardian is required.

    Name: ______________________________________________________________________
    (Please Print Full Name)
    Signature: _________________________________ Date: ____________


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