The American Legion Riders
Roy Fourr Post 24, Tombstone, AZ
Member Information Form / Application for Membership VER. 15 MAY 12

Last Name____________________________First Name________________________________
Nickname/Rider Name___________________________________________________________
Home Address___________________________________________________ Apt#___________
City____________________________ State___________ Zip___________
Home Phone (_____) _____-_______ Cell Phone (_____) _____-_______
Wife/Husband _________________________________________________
Birth Date ____/____/____ Email Address___________________________
Check One: Member of: __Legion__SAL__Auxiliary at Post#____ Membership #_________
Emergency Contact: Name_________________________ Phone (_____) ______-_______

About your bike: Complete this section if you will be riding a motorcycle with the ALR. Cross it out if you will be a supporter.
Make________________ Model________________ Displacement_______

About the lawyers: Check the box alongside the appropriate statement below. Draw a large X through the statement that does not
apply to you and sign and date. If you do not own a motorcycle and joining as a supporter, also draw a large X through the “About your bike” section above.
_______ “I, the undersigned, certify that the motorcycle listed above is registered in my and/or my ALR24 members spouses name, and is in accordance with state, city, and/or local licensing and registration requirements. I further certify that I carry and will maintain property and liability insurance for myself, my passengers,
and my motorcycle which meets at least the minimum state, city, and/or local insurance requirements. I also certify that I carry a valid
driver’s license with either a cycle endorsement or a valid Motorcycle Temporary Instruction Permit in accordance with state, city,
and/or local laws or if joining as a spouse of a member (initial if joining as a spouse of an ALR24 member______) I will not at any time operate a motorcycle. If my status changes, I will request and submit a new Member information form/Application for membership.”

Applicant must provide proof of ownership, insurance, motorcycle endorsement and membership of the Legion family prior to being voted in as a member.

_______ “I am joining as a non-dues paying supporter of the Riders: I will not be operating a motorcycle as an American Legion Rider, but may be participating in American Legion Rider events and/or as a passenger. If my status changes I will request, complete, and submit a new Member Information Form /Application for membership.”

All applicants, rather for membership or supporter, must signify their understanding and certification of the relative section above by signing and dating here.
“I, the undersigned, agree that the American Legion, and the American Legion Motorcycle Association (henceforth referred to as 'The American Legion Riders'
or simply as 'Riders'), shall not be liable or responsible for damage to property or injury to persons including myself during any Riders activities,
even where the damage or injury is cause by negligence (except willful neglect). I understand and agree that all Riders members and their guests
participate voluntarily, and at their own risk in all Riders activities. I release and hold the Riders officers and the American Legion harmless for any injury
loss to my person or property that may result from my participation in the Riders and/or their activities. I understand that this means that I agree
not to sue the Riders officers, whether local, state, or national, nor the American Legion for any injury resulting to myself or my property in connection with any Riders activities.”

Signed:_____________________________________________ Date:_________________________
All applicants, rather for membership or supporter, must signify their understanding of and agreement with the above by signing and dating here.
Complete and mail to:
Attn: ALR Post 24
PO Box 247 Tombstone, AZ 85638

FOR ALR24 USE

Application has been vetted by-President ALR24___________________ or Adjutant ALR24_______________________

Date vetted___________________