Low Profile Motorcycle Club
Membership Application
Name: __________________________________________________________________
Club/Ride Name: _________________________________________________________
Street Address: ___________________________________________________________
City/State/Zip: ___________________________________________________________
Birth Date: ______________________________________________________________
E-mail Address: __________________________________________________________
Home Phone #: ___________________________________________________________
Cell Phone #: ____________________________________________________________
Pager: __________________________________________________________________
Bike Year: _______________________ Make: _________________________________
Bike Model: ______________________ Tag #: _________________________________
Insurance Provider: _______________________________________________________
Driver’s License #: ___________________________________ State: _______________
Motorcycle Class: Yes (_____) No (______) Years Riding Experience: ______________
Emergency Contact:
1) Name: ____________________________________________________________
Phone #: __________________________________________________________
2) Name: ____________________________________________________________
Phone #: __________________________________________________________
• By signing this application, you attest that all information is true and accurate to the best of
your knowledge. Note that all dues are non-refundable. False and/or inaccurate information
may result in dismissal from the club. I understand that proceeds from club membership dues
contribute to the operation, maintenance and expenses of the club, club events and socials, either
directly or indirectly.
• I understand that the LOW PROFILE MOTORCYCLE CLUB does not assume
responsibility for any aspect of my safety and that if I participate in any sanctioned meet, I do so
voluntarily on my own assessment of my ability, assuming all risk. I release and hold the LOW
PROFILE MOTORCYCLE CLUB harmless for any injury or loss to my person or property which
may result there from. I understand that this means that I agree not to sue the LOW PROFILE
MOTORCYCLE CLUB for any injury resulting to myself or my passenger. I agree not to sue the
LOW PROFILE MOTORCYCLE CLUB for any personal property damage or any property
damage caused by me at any such meet, event, and/or ride. All rights reserved by the LOW
PROFILE MOTORCYCLE CLUB.
Signature: ______________________________________ Date: ___________________
Print application and mail along with non-refundable application fee of $25.00 to:
Low Profile Motorcycle Club
401 Finsbury Street #102
Durham, North Carolina 27703
Membership Application
Name: __________________________________________________________________
Club/Ride Name: _________________________________________________________
Street Address: ___________________________________________________________
City/State/Zip: ___________________________________________________________
Birth Date: ______________________________________________________________
E-mail Address: __________________________________________________________
Home Phone #: ___________________________________________________________
Cell Phone #: ____________________________________________________________
Pager: __________________________________________________________________
Bike Year: _______________________ Make: _________________________________
Bike Model: ______________________ Tag #: _________________________________
Insurance Provider: _______________________________________________________
Driver’s License #: ___________________________________ State: _______________
Motorcycle Class: Yes (_____) No (______) Years Riding Experience: ______________
Emergency Contact:
1) Name: ____________________________________________________________
Phone #: __________________________________________________________
2) Name: ____________________________________________________________
Phone #: __________________________________________________________
• By signing this application, you attest that all information is true and accurate to the best of
your knowledge. Note that all dues are non-refundable. False and/or inaccurate information
may result in dismissal from the club. I understand that proceeds from club membership dues
contribute to the operation, maintenance and expenses of the club, club events and socials, either
directly or indirectly.
• I understand that the LOW PROFILE MOTORCYCLE CLUB does not assume
responsibility for any aspect of my safety and that if I participate in any sanctioned meet, I do so
voluntarily on my own assessment of my ability, assuming all risk. I release and hold the LOW
PROFILE MOTORCYCLE CLUB harmless for any injury or loss to my person or property which
may result there from. I understand that this means that I agree not to sue the LOW PROFILE
MOTORCYCLE CLUB for any injury resulting to myself or my passenger. I agree not to sue the
LOW PROFILE MOTORCYCLE CLUB for any personal property damage or any property
damage caused by me at any such meet, event, and/or ride. All rights reserved by the LOW
PROFILE MOTORCYCLE CLUB.
Signature: ______________________________________ Date: ___________________
Print application and mail along with non-refundable application fee of $25.00 to:
Low Profile Motorcycle Club
401 Finsbury Street #102
Durham, North Carolina 27703
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