Membership

Dualies Membership Enrollment and Information Form

Rider Information

Name *

First

Last

Email *

Cell Phone Number *

Home Phone Number *

Street Address *

City *

State *

Zip Code *

AMA Membership Number *

AMA Membership Expiration Date *

Emergency Contact Info

Emergency Contact Name *

First

Last

Emergency Contact Phone Number *

Reason for joining the club? What Bikes do you have? *

Form Electronically Signed and submitted on website on this date: *

How did you learn about the club? *

Word of Mouth Club Ride Promotions Another Website

Please read the statement below and click submit to agree.

I understand I will be expected to participate in at least one club fundraising activity and attend at least once club meeting each year. I understand that the club membership period is a calendar year, from January 1st through December 31st of each year. Renewal is due by February 1st each year. New members who join the club after November 1st will have valid membership until December 31st of the following year.

As an Orange County Dualies Member, I agree to abide and support the club bylaws as adopted by the club. I also agree to hold the club and its officers harmless in the event that I am injured while participating in a club activity. I understand that the club is a non-profit corporation.

When complete, click submit. You'll be taken to our Paypal store website to complete your membership.

Submit