| BMW Motorcycle Owners of Georgia | Membership/Renewal Form Please make a hard copy, fill out completely, and mail to us! |
Member Information
| Member Name: | Month of Birthday | ||
| Associate Name: | Month of Birthday | ||
| Address | |||
| City | |||
| State | Zip + 4 | ||
| Home Phone | ( ) | Work Phone | ( ) |
| Fax Number | Pager Number | ||
| Are you willing to help with the annual Georgia Mountain Rally? (first weekend in May) (Circle one) Yes No Maybe | |||
| Current affiliations: (Circle all that apply) BMWMOA BMWRA AMA Write in - | |||
| Motorcycles you currently own: | R-Bikes: | ||
| K-Bikes: | |||
| Other bikes: | |||
Dues
| Dues | Circle One | |||
| Regular Member | $20.00/yr | New | Renewal | Regular members receive newsletter with voting rights and privileges |
| Associate Member | $10.00/yr | New | Renewal | Voting rights and privileges, but no newsletter |
| Annual Club Dues | $ |
| BMW Motorcycle Owners of Georgia Club Reflective Stickers - $1.00 each | $ |
Total Enclosed |
$ |
| Date of Application or Renewal |
**********************************************************************************************************************
Member to Member Business and Hobby Directory (Optional):
If you would like to be included in an upcoming Business/Hobby directory,
please fill out the following information.
With a membership exceeding 200 members, from stone masons to bankers, mechanics to
heating and air repair, from electricians to insurance brokers,
you may be able to do business with a fellow club member. If there is a positive response
to this survey, we will publish a directory.
| Occupation: | Years of Experience: | |||
| Other areas of expertise | ||||
| Services or products | ||||
| Phone | ( ) | Are you willing to offer free advice to a member? Yes / No | ||
| Hobbies and Interests | ||||
General Survey: Here is
your chance to help us serve you better. Please make any suggestions that you would like
to see implemented.
Saturday club rides? Weekend safety refresher course? Occasional pot luck dinners?
Saturday meetings? What would make you enjoy our club more fully?
| Who referred you to our club? | |
Please mail to:
BMW Motorcycle Owners of Georgia, Post Office Box 1089, Smyrna, GA 30081-1089
along with your check for dues.
Motorcycle Driver / Passenger Release Form
In consideration of being permitted to ride as a motorcycle driver and/or passenger in and otherwise to participate in the general activities of the BMW Motorcycle Owners of Georgia, Inc., a Georgia corporation, (hereinafter collectively the “Events”), the undersigned (hereinafter “Releaseor”) for him/herself, his/her spouse, legal representatives, heirs, and assigns, hereby RELEASES, WAIVES AND DISCHARGES the BMW Motorcycle Owners of Georgia, Inc., its agents, employees, members, sponsors, advertisers, promoters and affiliates (hereinafter collectively “Releasees”) from all liability to Releasor, his/her spouse, legal representatives, heirs and assigns for any and all loss or damage, and any claim or damages resulting therefrom, on account of injury to Releasor’s person or property, even injury resulting in death of Releasor, if caused by the negligence of Releasees while Releasor is participating as a motorcycle driver and/or passenger in the Events. I understand that the Events generally consist of, but are not necessarily limited to, group motorcycle rides on public highways.
I UNDERSTAND THAT THIS FORM AND RELEASE IS A CONTRACT WITH LEGAL CONSEQUENCES. I HAVE BEEN ADVISED TO READ IT CAREFULLY BEFORE SIGNING. In consideration of the acceptance of my application for entry in the Events, I hereby freely agree to and hereby make the following contractual representations and agreements: I acknowledge that motorcycling is an inherently dangerous activity and fully realize the dangers of motorcycling and FULLY ASSUME THE RISKS ASSOCIATED WITH SUCH PARTICIPATION INCLUDING, by way of example, and not limitation, the following: the dangers of collision with vehicles, including other motorcycles, pedestrians, and fixed or moving objects, including the pavement; the dangers arising from surface hazards, equipment failure, inadequate safety equipment, THE RELEASEES' OWN NEGLIGENCE, and weather conditions; and the possibility of serious physical and/or mental trauma or injury associated with motorcycling.
For myself, my heirs, executors, administrators, legal representatives, assignees, and successors in interest (collectively "Successors") I HEREBY WAIVE, RELEASE, DISCHARGE, HOLD HARMLESS, AND PROMISE TO INDEMNIFY AND NOT TO SUE THE RELEASEES FROM ANY AND ALL RIGHTS AND CLAIMS INCLUDING CLAIMS ARISING FROM THE RELEASEES' OWN NEGLIGENCE, which I have or which may hereafter accrue to me and from any and all damages which may be sustained by me directly or indirectly in connection with, or arising out of, my participation in or association with the Events, or travel to or return from the Events. I understand and agree that situations may arise during the Events which may be beyond the immediate control of Releasees, and I must continually act so as to neither endanger myself nor others.
I accept responsibility for the condition and adequacy of my motorcycle, my clothing and my other protective gear. I understand that it is recommended that I wear the following clothing and protective equipment when participating in motorcycling activities: sturdy boots that cover and protect the ankle and leg, leather, padded gloves, pants and jacket constructed of sturdy material, a visibility vest, and a full faced helmet approved by the U.S. Department of Transportation and the Snell Memorial Foundation that can help protect against serious head injury. I assume all responsibility and liability for the selection of such clothing, and protective equipment. I understand that such protective clothing and other devices will not protect against every possible injury that can be incurred while driving a motorcycle; and, in fact, even while using such clothing and protective devices I can still incur serious bodily injury or even die as the result of participating in the Events. I have no physical or medical condition which to my knowledge, would endanger myself or others if I participate in the Events, or would interfere with my ability to participate in the Events. I am not in the habit of becoming under the influence of any substance
that might impair my ability to participate in the Events. I agree, for myself and my successors, that the above representations are contractually binding, and are not mere recitals, and that should I or my successors assert any claim in contravention of this agreement, the asserting party shall be liable for the expenses (including legal fees) incurred by the other party or parties in defending, unless the other party or parties are finally adjudged liable on such claim for willful and wanton negligence, gross negligence, or recklessness.
I agree that this agreement may not be modified orally, and a waiver of any provision shall not be construed as a modification of any other provision herein or as a consent to any other provision herein or as a consent to any subsequent waiver or modification. This Agreement, and the application and interpretation thereof, shall be governed exclusively by the laws of the State of Georgia. This agreement shall be construed under Georgia law. Every term and provision of this agreement is intended to be severable. If any one or more of them is found to be unenforceable or invalid, that shall not affect the other terms and provisions, which shall remain binding and enforceable.
Name (print)
__________________________________________________________________________
Phone #_______________________
Street ______________________________________________ Apt./Ste. _____________
City _______________________ State ________________ Zip __________
Whom to notify in case of emergency:
Phone #
Signature of Releasor
Consent and Release of Parent or Guardian
I am the parent or guardian of (hereinafter my “Child”). My Child is fit to participate in the Events, and I consent to my Child's participation. I HAVE READ AND I UNDERSTAND The Motorcycle Driver / Passenger Release Form. In consideration of allowing my Child to participate in the Events, I consent to it and agree that ITS TERMS SHALL LIKEWISE BIND ME, MY CHILD, my heirs, legal representatives, and assignees. I HEREBY RELEASE AND SHALL DEFEND, INDEMNIFY AND HOLD HARMLESS THE RELEASEES FROM EVERY CLAIM AND ANY LIABILITY that I or my Child may allege against the Releasees (including reasonable attorney's fees or costs) as a direct or indirect result of injury to me or my Child because of my Child's participation in the Event WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES or others. I PROMISE NOT TO SUE RELEASEES on my behalf or on behalf of my Child regarding any claim arising from my Child's participation in the Events.
Signature of parent or guardian:
Date_______________________