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Membership/Race Forms
Applicant Information:
Join the American Historic Racing Motorcycle Association www.ahrma.org □ New or □ Renewal: AHRMA Membership # __________
Name: Roadrace Transponder #
Permanent Address: City: Country: State / Province: Cell Phone: ZIP / Postal Code: Date of Birth*:
Daytime Phone: Emergency Phone: Email:
*(21 years or younger must provide proof of age - driver’s license, birth certificate, or school identification with DoB)
Full Membership
Come out and try your hand at racing. (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) Associate Membership 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)
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 Cross Country - Skill level if different from MX: □ Intermediate □ Expert □ Master □ 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): For more information: 26 Jardin de Mer Place, Jacksonville, FL 32250 Phone: 904.477.6987 Scan & email: cindy.mclean@ahrma.org Email: cindy.mclean@ahrma.org www.ahrma.org REV 12/9/19
Personal Medical Insurance Company & Policy #:
Pre-Entry fee: $40 per class/Post-Entry fee: $45 per class. Fees must accompany entry form or entry will not be accepted. For information on refunds or credit towards future events, see section 4.7 of the AHRMA Handbook.
READ THIS RELEASE
RELEASE: I hereby release and agree to hold harmless AHRMA, the promoters, the owners and lessees of the premises, the participants, sponsors, and the officers, directors, officials, representatives, agents and employees of all of them of and from all liability, loss, claims and demands that may accrue from any loss, damage or injury (including death, loss of limbs and permanent disablement) to my person or property, in any way resulting from, or arising in connection with this event, and whether arising while engaged in competition or in practice or preparation therefore, or while upon, entering or departing from said premises, from any cause whatsoever. I know the risk and danger to myself and property while upon said premises or while participating or assisting in the event, so voluntarily and in reliance, upon my own judgment and ability, and I thereby assume all risk for loss, damage or injury (including death, loss of limbs and permanent disablement) to myself and my property from any cause whatsoever. I have no known PHYSICAL PROBLEMS that will endanger me or others while participating in this event. My helmet meets all standards as specified in the current AHRMA Handbook.
AGREEMENT: By my signature below, I hereby agree to the terms of the above release, guarantee credit card payment and further agree to abide by the AHRMA Handbook and any special regulations during the event.
________________________________________________ (RIDER SIGNATURE)
Event information: www.ahrma.org
AHRMA Membership information: cindy.mclean@ahrma.org or 904.477.6987
Refer to the current AHRMA Handbook (Also available online at www.ahrma.org) for questions regarding classes and eligibility. See Section 18 for Rules & Eligibility committee personnel and other Officials.
WWW.AHRMA.ORG Class
Modern Classic Classic Modern Twin Shock Premier Lightweight Premier Heavyweight Rigid Lightweight Rigid Heavyweight Girder Fork Beginner Support Class Youth A Youth B Youth C
Model Year Machine Brand/ Chassis Engine Size (cc) Skill Level Entry Fee
AHRMA Membership (if due, $75; International, see membership form) Benevolent Fund or Individual Donation to AHRMA
TOTAL FEES
MC/Visa/Disc/AmEx _________________________________Exp. Date ______ CVV Code ______
Street # __________________________________________________ ZIP Code _____________
Send completed entry form to: AHRMA, 49 Ferguson Lane, Elora, TN 37328; 931.308.0338; email curt.comer@ahrma.org Please Print Clearly!
AHRMA Membership # ___________ Bike # ______ Event Date/Name: _________________________________________ Name: _____________________________________ Address: _________________________________________________ City, State, ZIP Code: ____________________________________________________________________________________ Phone: ________________________Mobile Phone: _______________________ Email: ____________________________ Personal Medical Insurance Company & Policy #: ____________________________________________________________ Sponsors: _____________________________________________________________________________________________
Pre-entry: First class, $45; each additional class, $30. Race day entry: First class, $60; each additional class, $35. Pre-entries are due 16 days prior to the event. Fees must accompany entry form or entry will not be accepted. For information on refunds or credit towards future events, see section 4.7 of the AHRMA Handbook.
READ THIS RELEASE
RELEASE: I hereby release and agree to hold harmless AHRMA, the promoters, the owners and lessees of the premises, the participants, sponsors, and the officers, directors, officials, representatives, agents and employees of all of them of and from all liability, loss, claims and demands that may accrue from any loss, damage or injury (including death, loss of limbs and permanent disablement) to my person or property, in any way resulting from, or arising in connection with this event, and whether arising while engaged in competition or in practice or preparation therefore, or while upon, entering or departing from said premises, from any cause whatsoever. I know the risk and danger to myself and property while upon said premises or while participating or assisting in the event, so voluntarily and in reliance, upon my own judgment and ability, and I thereby assume all risk for loss, damage or injury (including death, loss of limbs and permanent disablement) to myself and my property from any cause whatsoever. I have no known PHYSICAL PROBLEMS that will endanger me or others while participating in this event. My helmet meets all standards as specified in the current AHRMA Handbook.
AGREEMENT: By my signature below, I hereby agree to the terms of the above release, guarantee credit card payment and further agree to abide by the AHRMA Handbook and any special regulations during the event.
________________________________________________ (RIDER SIGNATURE)
Event information: www.ahrma.org
AHRMA Membership information: cindy.mclean@ahrma.org or 904.477.6987
Class
Premier Lightweight Premier 350 Premier 500 Premier Open Twins Classic 125 Classic 250 Classic 500 Early Sportsman Stock 250 Early Sportsman Stock 500 100cc Motocross Sportsman 125 Sportsman 250 Sportsman 500 Sportsman Open Twins
Model Year Machine Brand/ Chassis Engine Size (cc)
Ultima 125 Ultima 250 Ultima 500 Vintage Open Age Vintage 40+ Vintage 50+ Vintage 60+ Vintage 70+ Women AHRMA Membership (if due, $75; International, see membership form) Benevolent Fund or Individual Donation to AHRMA
TOTAL FEES
Skill Level Entry Fee
Refer to the current AHRMA Handbook (Also available online at www.ahrma.org) for questions regarding classes and eligibility. See Section 18 for Rules & Eligibility committee personnel and other Officials.
WWW.AHRMA.ORG MC/Visa/Disc/AmEx _________________________________Exp. Date ______ CVV Code ______
Street # __________________________________________________ ZIP Code _____________
2020 AHRMA - Race Tech National Post Vintage Motocross Series Entry Form
AHRMA Membership # ___________ Bike # ______ Event Date/Name: _________________________________________ Name: _____________________________________ Address: _________________________________________________ City, State, ZIP Code: ____________________________________________________________________________________ Phone: ________________________Mobile Phone: _______________________ Email: ____________________________ Personal Medical Insurance Company & Policy #: ____________________________________________________________ Sponsors: _____________________________________________________________________________________________
Pre-entry (Mail-In): First class, $45; each additional class, $30 Race day entry: First class, $60; each additional class, $35. Pre-entries are due 16 days prior to the event. Fees must accompany entry form or entry will not be accepted. For information on refunds or credit towards future events, see section 4.7 of the AHRMA Handbook.
READ THIS RELEASE
RELEASE: I hereby release and agree to hold harmless AHRMA, the promoters, the owners and lessees of the premises, the participants, sponsors, and the officers, directors, officials, representatives, agents and employees of all of them of and from all liability, loss, claims and demands that may accrue from any loss, damage or injury (including death, loss of limbs and permanent disablement) to my person or property, in any way resulting from, or arising in connection with this event, and whether arising while engaged in competition or in practice or preparation therefore, or while upon, entering or departing from said premises, from any cause whatsoever. I know the risk and danger to myself and property while upon said premises or while participating or assisting in the event, so voluntarily and in reliance, upon my own judgment and ability, and I thereby assume all risk for loss, damage or injury (including death, loss of limbs and permanent disablement) to myself and my property from any cause whatsoever. I have no known PHYSICAL PROBLEMS that will endanger me or others while participating in this event. My helmet meets all standards as specified in the current AHRMA Handbook.
AGREEMENT: By my signature below, I hereby agree to the terms of the above release, guarantee credit card payment and further agree to abide by the AHRMA Handbook and any special regulations during the event.
________________________________________________ (RIDER SIGNATURE)
Event information: www.ahrma.org
AHRMA Membership information: cindy.mclean@ahrma.org or 904.477.6987
Refer to the current AHRMA Handbook (Also available online at www.ahrma.org) for questions regarding classes and eligibility. See Section 18 for Rules & Eligibility committee personnel and other Officials.
WWW.AHRMA.ORG Class
PV100 Historic 125 Historic 250 Historic 500 Historic Four-Stroke Grand Prix 125 Grand Prix 250 Grand Prix 500 Ultima 125 Ultima 250 Ultima 500 Ultima Four-Stroke Post Vintage Open Age Post Vintage 40+ Post Vintage 50+ Post Vintage 60+ Post Vintage 70+
Model Year Machine Brand/ Chassis Engine Size (cc)
Post Vintage Women Pre-Modern 125 Pre-Modern 250 Pre-Modern 500 Pre-Modern 4 - Stroke AHRMA Membership (if due, $75; International, see membership form) Benevolent Fund or Individual Donation to AHRMA
TOTAL FEES
Skill Level Entry Fee
MC/Visa/Disc/AmEx _________________________________Exp. Date ______ CVV Code ______
Street # __________________________________________________ ZIP Code _____________
2020 AHRMA National Next Gen Motocross Series Entry Form
Pre-entry: First class, $45; each additional class, $30. Race day entry: First class, $60; each additional class, $35. Pre-entries are due 16 days prior to the event. Fees must accompany entry form or entry will not be accepted. For information on refunds or credit towards future events, see section 4.7 of the AHRMA Handbook.
READ THIS RELEASE
RELEASE: I hereby release and agree to hold harmless AHRMA, the promoters, the owners and lessees of the premises, the participants, sponsors, and the officers, directors, officials, representatives, agents and employees of all of them of and from all liability, loss, claims and demands that may accrue from any loss, damage or injury (including death, loss of limbs and permanent disablement) to my person or property, in any way resulting from, or arising in connection with this event, and whether arising while engaged in competition or in practice or preparation therefore, or while upon, entering or departing from said premises, from any cause whatsoever. I know the risk and danger to myself and property while upon said premises or while participating or assisting in the event, so voluntarily and in reliance, upon my own judgment and ability, and I thereby assume all risk for loss, damage or injury (including death, loss of limbs and permanent disablement) to myself and my property from any cause whatsoever. I have no known PHYSICAL PROBLEMS that will endanger me or others while participating in this event. My helmet meets all standards as specified in the current AHRMA Handbook.
AGREEMENT: By my signature below, I hereby agree to the terms of the above release, guarantee credit card payment and further agree to abide by the AHRMA Handbook and any special regulations during the event. Class
ALL CLASSES INTMD & EXP ONLY Next Gen 1 - 125 Next Gen 1 - 250 Next Gen 1 - 500 Millenium Two-Stroke 125 Millenium Two-Stroke 250 Current Two-Stroke 125AM Current Two-Stroke 250AM Current Two-Stroke Unlimited Next Gen 40+ Next Gen 50+ Next Gen 60+
Model Year Machine Brand/ Chassis Engine Size (cc)
AHRMA Membership (if due, $75; International, see membership form) Benevolent Fund or Individual Donation to AHRMA
TOTAL FEES
Skill Level Entry Fee
________________________________________________ (RIDER SIGNATURE)
Event information: www.ahrma.org
AHRMA Membership information: cindy.mclean@ahrma.org or 904.477.6987
Refer to the current AHRMA Handbook (Also available online at www.ahrma.org) for questions regarding classes and eligibility. See Section 18 for Rules & Eligibility committee personnel and other Officials.
WWW.AHRMA.ORG MC/Visa/Disc/AmEx _________________________________Exp. Date ______ CVV Code ______
Street # __________________________________________________ ZIP Code _____________
AHRMA National Historic Cup Roadrace events utilize MYLAPS transponders for timing and scoring. We have selected MYLAPS based on several considerations, which include performance experienced by other racing organizations and integration with our SeriesTracker online registration and event- scoring software. The MYLAPS transponders compatible with our scoring system are: Bike Classic, Bike Flex and Bike Direct Power. Any one of these models is to be mounted vertically (pin pointing upward) on either fork leg, no more than 42 inches off the ground.
# of Days Rental:__________________MC/Visa/Disc/AmEx: _____________________________________________________________ Exp. Date: ______________ CVV code:____________ Signature___________________________________________________________ Please ensure your credit card billing address and ZIP Code are included; your card will not be charged until after the event Pricing and additional rental responsibilities: • Rental fee is $30 per day at all roadrace events; reservations must be made in advance. • Transponders may be picked up at registration, and must be returned at the end of the event to avoid extra charges. • Note: Reserved transponders that are not picked up are subject to the full rental charge for the event. • Transponders not returned are subject to replacement charges, which may exceed $400.
Send completed entry form to RR Directors / AHRMA Mail PO Box 31, Horton, AL 35980 • Fax: 256.660.1366 • Scan and Email: ahrma@oneracing.org For more information call: 256.506.6603 07/12/2019
1981 Honda XR100 AHRMA Transponder Rental Form AHRMA National Historic Cup Roadrace events utilize MYLAPS transponders for timing and scoring. We have selected MYLAPS based on several considerations, which include performance experienced by other racing organizations and integration with our SeriesTracker online registration and event- scoring software. The MYLAPS transponders compatible with our scoring system are: Bike Classic, Bike Flex and Bike Direct Power. Any one of these models is to be mounted vertically (pin pointing upward) on either fork leg, no more than 42 inches off the ground.
AHRMA Membership # ______________ Bike # _______ Event Name: ___________________________________________________ Raffle bike! AHRMA Benevolent Fund AHRMA Benevolent Fund Raffle bike! Name: _________________________________________ Address: _______________________________________________________ City, State, ZIP Code: ______________________________________________________________________________________________ Phone: ____________________________Mobile Phone: _______________________ Email: ____________________________________ # of Days Rental:__________________MC/Visa/Disc/AmEx: _____________________________________________________________ For the past three years, Gary Swan, of Toad Town Racing, has donated a motorcycle to be raffled off at the end of the season. Toad Town Racing has donated over $5000 the past three years to the AHRMA Benevolent Fund (for injured riders who need monetary aid). This year, Toad Town Racing will donate an all original 1981 Honda XR100. During the next couple of months, this XR will get a new top Pricing and additional rental responsibilities: • Rental fee is $30 per day at all roadrace events; reservations must be made in advance. • Transponders may be picked up at registration, and must be returned at the end of the event to avoid extra charges. • Note: Reserved transponders that are not picked up are subject to the full rental charge for the event. • Transponders not returned are subject to replacement charges, which may exceed $400. Exp. Date: ______________ CVV code:____________ Signature___________________________________________________________ Please ensure your credit card billing address and ZIP Code are included; your card will not be charged until after the event end, control cables, drive chain and a cosmetic makeover.
Send completed entry form to Tickets will be available at all National roadrace events or through Toad Town Racing. $5.00 per ticket or five tickets for $20.00 RR Directors / AHRMA Mail PO Box 31, Horton, AL 35980 • Fax: 256.660.1366 • Toad Town Racing phone: 818-675-5625 Scan and Email: ahrma@oneracing.org For more information call: 256.506.6603 07/12/2019
