Join the American Historic Racing Motorcycle Association www.ahrma.org
Applicant Information:
□ New or □ Renewal: AHRMA Membership # __________
Name:
Roadrace Transponder #
Permanent Address: City:
State / Province:
ZIP / Postal Code:
Country: Daytime Phone:
Cell Phone: Emergency Phone:
Date of Birth*: Email:
*(21 years or younger must provide proof of age - driver’s license, birth certificate, or school identification with DoB)
Full Membership
Associate Membership
Come out and try your hand at racing. (Check all boxes that apply)
If you enjoy coming to the races, are enthusiastic about vintage bikes, love reading about bikes, but don’t compete, this is for you. Associate members DO NOT have voting privileges. (Check all boxes that apply)
□ Full Membership – $75 (US), $85 (Canada or Mexico), or $95 (overseas)
(Includes competition & voting privileges, decals, membership card, and annual Handbook. Note: Only US residents automatically receive AHRMA Mag; others see below.)
□ Upgrade to delivery of AHRMA Mag via First Class Mail - add $11 (US members only) □ AHRMA Mag for residents of Canada or Mexico - add $11 □ AHRMA Mag for residents of all other foreign nations - add $22 □ Lifetime Competition Membership $650 (Must be 60 years or older)
□ New members or reactivating - $40 (US), $45 (Canada or Mexico), or $50 (overseas)
(Includes decals, membership card, and annual Handbook. Note: Only US residents automatically receive AHRMA Mag; others see below.)
□ Upgrade to delivery of AHRMA Mag via First-Class Mail - add $11 (US members only) □ AHRMA Mag for residents of Canada or Mexico - add $11 □ AHRMA Mag for residents of all other foreign nations - add $22
The Details (For new members only - Competition preferences)
□ Race number preference (for all disciplines - list three or more - your permanent number will be on your membership card
when received): #1 _______ #2 _______ #3 _______Note: If assigned a number on race day, it will not be your permanent number.
□ Roadrace - Before AHRMA issues a racing number, you must provide proof that within the past two years, you have
competed with another roadracing organization or have successfully completed a roadracing school (please provide a copy of roadrace license or school certificate)
□ Motocross - □ Vintage □ Post Vintage □ Next Gen Indicate MX skill level: □ Intermediate □ Expert
Note: A Novice category is available. However, new AHRMA MX members must ride as Intermediate or Expert until skill-level status is confirmed, optimally at your first event. At that time, you may be reclassified as a Novice if deemed appropriate.
□ Dirt Track □ Trials - Skill level: □ Beginner □ Novice □ Intermediate □ Expert □ Master □ Cross Country - Skill level if different from MX: □ Intermediate □ Expert (See note above regarding Novice skill level.) Payment
□ Enclosed is a check or money order for $__________________ # __________ □ Please charge my MC / Visa / Disc / AmEx: Credit card # ________________________________ Expires _______ cvv _____ Must include street number and ZIP code for credit card billing address. If different than address above, please provide billing address. □ Benevolent Fund donation $ _________________ or □ Individual donation to AHRMA $ _________________ By applying for or renewing and accepting membership in AHRMA, I agree to abide by all rules of the AHRMA Handbook, as well as any event or track rules that may apply. Signature (must be signed to be valid and processed) ____________________________________________Date _____________
Mail with payment to (payment by MC / Visa / Disc / AmEx): 26 Jardin de Mer Place, Jacksonville, FL 32250 Scan & email: cindy.mclean@ahrma.org
SEPTEMBER/OCTOBER 2020
For more information:
Phone: 904.477.6987 Email: cindy.mclean@ahrma.org www.ahrma.org REV 12/9/19
AMERICAN HISTORIC RACING MOTORCYCLE ASSOCIATION
WWW.AHRMA.ORG
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