Membership Form – Cold Lake Motocross

Membership Application

Section 1: Consent

This section is for consent only.

Adult, Parent or Guardian

Must be 18 years of age to complete this application.

First Name

Last Name

Birth Date

Address

City

Province

Postal Code

Phone/Mobile

Emergency Contact

Emergency Contact Number

Consent, Release and Waiver of Liability

I have read, understand and agree to this Release and Waiver of Liability, Assumption of Risk and Indemnity Agreement.

Are any riders under the age of 18?

I have read, understand and agree to the Parental Consent, Release and Waiver of Liability, Assumption of Risk, and Indemnity Agreement.

Section 2: Pass and Rider Info

Membership and Passes

What day are you planning to ride?

What day are you planning to camp?

How many in your Family?

Rider Information

Full Name

Birth Date

Age

Skill Level

Bike Make/Model

Second Rider

Full Name

Birth Date

Age

Skill Level

Bike Make/Model

Third Rider

Full Name

Birth Date

Age

Skill Level

Bike Make/Model

Fourth Rider

Full Name

Birth Date

Age

Skill Level

Bike Make/Model

Fifth Rider

Full Name

Birth Date

Age

Skill Level

Bike Make/Model

I have read and agree to the Membership Guidlines.