TO JOIN PRINT, SIGN AND BRING T=
HIS
FORM TO THE NEXT MEETING
![](3D"GKMMClubSFABAPP_files/image002.jpg")
Green
Knights Military Motorcycle Club
Chapter
54, Sheppard AFB
Personal Information:
Name: Last
__________________________ First _____________________M.I. _____
Associate Member
Name__________________________________________________
Residential
address:
_____________________________=
___________________________________________
Street city state zip
Home no.
(_____)_____________________Work no.(______)_____________________
Home
Email Address
_____________________________
Work
Email Address_______________________________
(Primary) Bike Information:
Type (circle on=
e): cruiser
dirt motocross sport other
Year: _____
Do you cur=
rently
own more than one bike? Y N
If yes, br=
iefly
describe (as
above) the other bike(s):
_____________________________=
___________________________________________
_____________________________=
___________________________________________
Rider Information:
Years of r=
iding
experience (circle
one): 0-1 1-3 3-5 5-10 10+
Riding cou=
rses
taken:
1)___________________________=
__________________________________________
Name of course Name of school,
location
2)___________________________=
__________________________________________
Name of course Name of school,
location
Mentorship Information:
If qualifi=
ed,
would you be interested in being a mentor? Y / N
What area or what type of =
bike
would you like to mentor on?_______________________
(answer)_____________________=
____________________________________________
Regardless=
of
years of experience, would you like to have a mentor? Y / N
If yes, in=
what
area would you like to be mentored in______________________________
Questions,
comments, or suggestions for what you want to see in the bike club this yea=
r:
_____________________________=
___________________________________________
_____________________________=
___________________________________________
Sheppard Green Knights Chapter 54
Assumption of Risk and Waiver of Liability
I, the
undersigned, know that motorcycle riding is a potentially hazardous activit=
y,
and I freely and knowingly attend riding activities sponsored by the Sheppard Green Knights Chapter 54. In
choosing to participate in riding activities sponsored by the Sheppard Green Knights Chapter 54, I
fully accept and assume all risks associated with those events. These inclu=
de,
without limitation, physical injury, mental injury, emotional distress, tra=
uma,
illness, death, contact with other participants, motorcycle failure, equipm=
ent
failure, the effects of weather including extreme temperature or conditions,
traffic, collision with other riders or fixed objects, road conditions, and
participation in miscellaneous events along any road routes. All risks are
known and appreciated by me. I waive any and all specific notice of the
existence of the risks.
Knowing
these facts and in consideration of my acceptance as a participant in Sheppard Green Knights Chapter 54
sponsored riding activities, I hereby agree not to hold Sheppard Green Knights Chapter 54 as a group and Sheppard Green Knights Chapter 54
leadership as individuals liable for any claims, demands, or actions of any
kind relating in any respect to my participation in Sheppard Green Knights Chapter 54 and Sheppard Green Knights Chapter 54 sponsored riding events. My
waiver and release of all claims, demands, actions, and liability shall inc=
lude
without limitation any injury, damage or loss to my person or property which
may be sustained by me before, during, or after any Sheppard Green Knights Chapter 54 sponsored riding events. I
further agree to indemnify and hold the parties released above harmless from
any and all losses, damages, claims, and expenses, including attorneys fees,
arising from or relating in any respect to my participation in Sheppard Green Knights Chapter 54 or
its related events.
IAW AFI 34-223, Paragra=
ph
10.11, I understand that the Shep=
pard
Green Knights Chapter 54, a private organization on Sheppard AFB,
operates with no liability or fidelity insurance. I fully understand that a=
s a
member of the Sheppard Green Knig=
hts
Chapter 54 I am required to maintain liability insurance, meeting the
minimum requirements of the state of Texas, and may be held jointly and
severally liable for any liability, including but not limited to personal
injuries, property damage, claim and expenses, through the acts that could
result in termination as a member identified in the Sheppard Green Knights Chapter 54 constitution and by-laws
associated with the activities of the Sheppard
Green Knights Chapter 54.
I
attest I have read, fully understand, and accept these terms. By signing th=
e application
I agree and accept the rights and responsibilities of my membership in the =
Sheppard Green Knights Chapter 54.
Applicants
Name____________________________________________
Signature__________________________________________________
Date______________________________________________________
GK
Officers Name___________________________________________
Signature___________________________________________________
Date_______________________________________________________