Memberships

Type of Membership

Yearly ($30) Runs from current day until the last day of present year

One Day ($10)

Family of 3 ($75)

First Name(Required)

Middle Name(Required)

Last Name(Required)

First Name (Rider 2)(Required)

Middle Name (Rider 2)(Required)

Last Name (Rider 2)(Required)

First Name (Rider 3)(Required)

Middle Name (Rider 3)(Required)

Last Name (Rider 3)(Required)

Age(Required)

Birthday(Required)

Present Bike Number(Required)

Age (Rider 2)(Required)

Birthday (Rider 2)(Required)

Present Bike Number (Rider 2)(Required)

Age (Rider 3)(Required)

Birthday (Rider 3)(Required)

Present Bike Number (Rider 3)(Required)

Classes Participating In(Required)

Classes Participating In (Rider 2)(Required)

Classes Participating In (Rider 3)(Required)

Riders Name (To be used in place of handwritten signature for all riders)(Required)

Mother's/Father's Name (If rider is under 18, and to be used in place of signature)(Required)

Email(Required)

Phone(Required)

AMA Number(Required)

AMA Number (Rider 2)(Required)

AMA Number (Rider 3)(Required)

AMA Expiration Date(Required)

AMA Expiration Date (Rider 2)(Required)

AMA Expiration Date (Rider 3)(Required)

Number of years as AMA member (on AMA card)(Required)

Number of years as AMA member (on AMA card) (Rider 2)(Required)

Number of years as AMA member (on AMA card) (Rider 3)(Required)

Today's Date(Required)

Consent(Required)

Read the following:
In consideration of being granted an Amateur Competition Card and in consideration of being permitted to participate as a rider or a pit crewman in Amateur events sanctioned by the American Motorcyclists Association:

I, for myself, my heirs, my personal representatives and assigns, hereby give up all rights to sue or make any claim whatsoever against and agree to hold harmless and indemnify the Virginia Motorcycle and ATV Racing Association, Inc., dba as AMA District 13 MX, the American Motorcyclists Association and its district organizations, the American All Terrain Vehicle Association, the promoters presenting sanctioned events, owners and lessees of premises on which sanctioned events take place, the participants in sanctioned events, the owners and sponsors of manufacturers of all racing equipment upon the premises, and all other persons or organizations conducting or connected with these events for any injury to my property or person I may suffer, including crippling injury or death, whether such injury arises while I am preparing for or participating in the event, while I am upon the event premises or entering or departing from said premises. I know the risks of danger to myself and property while participating in the event and while upon the event premises and, relying upon my own judgment and ability, assume all such risks of loss (including crippling injury and death) from any cause whatsoever whether or not attribute to the negligence of others.

I agree that the Virginia Motorcycle and ATV Association, Inc. dba AMA District 13 MX or its assigns may use my name and pictures, including pictures of my racing equipment and pictures taken at any sanctioned event.

I understand that an Amateur Competition Card is subject to American Motorcyclists Association Rules for Competition.

I HAVE READ THE ABOVE ASSUMPTIONS OF RISK. I FULLY UNDERSTAND WHAT IT MEANS, AND I HAVE SIGNED IT VOLUNTARILY.

I/We hereby make oath and say that to the best of our knowledge and belief, all statements set forth in the report are true and correct

I agree

Home Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Billing Address(Required)

Same as home address

Card Holder Name(Required)

First Last

Credit Card(Required)

Total

Phone

This field is for validation purposes and should be left unchanged.

Virginia Motorcycle Racing Association, Inc. dba AMA District 13 MX

Virginia Motorcycle Racing Association, Inc.
dba AMA District 13 MX