Would you like your phone number and email address added to our Member's Map. This information will only be provided with your permission. Yes No

Personal Information (must be filled out completely):

Name:                  Delphi Screen Name:   

Mailing Address:                 County:   

City:         State: AK AL AR AZ CA CO CT DE DC FL GA HI IA ID IL IN KS KY LA MA MD ME MN MO MS MT NC ND NE NH NJ NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY State/Country Puerto Rico Canada Australia Virgin Islands             Zip Code:

Note:   Out of state members will be accepted ONLY upon approval from SSOA Council.

Phone:              Fax:         Mobile: 

Email address:            Male     Female

Age:           Birthday: mm Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec /dd 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 /yyyy 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Bike Info:             Year: 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010         Make:          Model:

Purchase date:   Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec / 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010         Nickname (if your bike has one):

We will be including emergency information on the membership cards. Please indicate if you would like this information added to your card. Yes No

Emergency Information:    Blood Type:         Allergies:     Medication:

Doctor's Name:     Doctor's Phone Number:

In case of emergency contact: Name:     Number:

Shooting Stars Over Alabama Indemnification Statement

The Shooting Stars Over Alabama (hereafter known as Shooting Stars), including its presence on the Internet in various forms, is not sanctioned by any other organization or individual. The Shooting Stars organization, its representatives, office holders, officials, sponsors or any individual member(s) of the Shooting Stars connected to it in any manner, can never be held liable for, or assume any responsibility for; 1) any person's participation or attendance at any event, ride or meeting held under the auspices of the Shooting Stars; 2) any property lost, stolen or damaged during such events, rides or meetings; 3) any physical or mental injury sustained during said events, rides or meetings; 4) any personal injury or property damage sustained as a direct or indirect result of any alteration of or modification to any motorcycle by any person based on information obtained from the Shooting Stars. All individuals accept complete responsibility for his/her own self while attending or participating in any event, or in making any alterations or modifications to a motorcycle, with no recourse against the Shooting Stars or any individual connected in any manner to the Shooting Stars, or acting as its officer, agent, employee, consignee, vendor or sponsor.

By clicking below, you understand and agree to the Shooting Stars member indemnification statement as stated above.