This form MUST be filled out by Chapter Officer

In signing this document, I represent that I am fully knowledgeable of the danger and hazards associated with riding motorcycles. I certify that I am duly licensed and competent to operate a motorcycle in a safe manner and is in safe operating condition. I will be riding on public highways and roadways and I am solely responsible to determine the speed and operational characteristics of my motorcycle while participating in the rides. I am licensed to operate a motorcycle and always carry motorcycle liability insurance as required by law.

I hereby release and hold harmless CHROME ANGELZ RC, its CHAPTER listed above, and/or any of its executives or members against all claims, causes of action, or any other liability of any kind arising from my activity of riding by motorcycle.

I certify that I have no known physical or mental impairment that may affect my safety or the safety of the group. I understand that the choice of wearing a helmet or other protective gear is solely my own choice and that I am responsible for my own compliance with all state laws, including those who require helmets. I certify that I am not under the influence of any narcotics, alcohol or any other drug that may impair my understanding or judgment and that I will not, at any time during the ride, operate my motorcycle under the influence of any narcotic, alcohol, or any drug.

I understand that this waiver and release is in force from January 1 through December 31 of the selected waiver year below, and covers any and all Chrome Angelz RC activities, rides, events, meetings, fundraisers, and related activities.

THE MOTORCYCLE SAFETY FOUNDATION ESTIMATES THAT 40% OF MOTORCYCLISTS ARE LICENSED. AN OFFICER MUST VERIFY THE MOTORCYCLE ENDORSEMENT OF EACH MEMBER.

EMERGENCY INFORMATION