APPLICATION FOR MEMBERSHIP
Retreads® Motorcycle Club International, Inc.
AMA Charter 3233

New Renewal

Date: 

Name:

Spouse:  

Address: 

 

City:

    State:        Zip Code: 

Telephone: 

E-Mail: 

Your Birthdate: 

Spouse Birthdate: 

AMA Number (if member): 

Expiration Date: 

Other motorcycling affiliations: 

Occupation: 

Hobbies:  
Make(s) of Motorcycles: 

Donation: 

Minimum of $15 single, $20 w/spouse suggested)
   

Referred by: 

 
   
I understand that the Retreads® cannot assume responsibility for any aspect of my safety.  I understand that my participation in any Retreads® activity is strictly voluntary and further, I release and hold harmless the Retreads® or any Retreads® member from any loss to my person or property.
       
Signature: 

Spouse: 

Date:   
     

Please make checks payable to:

Bill McCluskey

Mail your check with applications to:

 Felicia Sullivan
4908 Rattlesnake Dr.
Missoula, MT  59802