BMW Motorcycle Owners of America [MOA] Chapter #188
Legibility
counts!
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Date:______________
Name:_________________________
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 # __________)