BMWCOSC Membership Application

BMW Club of Southern California

BMWCOSC

New Membership Application

To join the BMW (Motorcycle) Club of Southern California, please fill out the information below and sign the acknowledgment. Membership can be paid online via PayPal as the last step in this signup process, or by sending a check payable to BMWCOSC along with this form to: BMW Club of Southern California, 5737 Kanan Road #169, Agoura Hills, CA 91301. Please note that your membership is not active until we receive this completed and signed form, regardless of payment method.

By signing your name below and submitting this application, you hereby acknowledge the following as a condition of membership:

I acknowledge the perils of motorcycle riding and accept personal responsibility for my personal safety and the safety of my passenger, if any.
I acknowledge the absence of liability on the part of the BMWCOSC for their role in organizing and conducting any group ride
I accept arbitration as the sole method for resolving any legal dispute with the BMWCOSC as a condition of acceptance into membership in the organization
I accept responsibility to pay the attorney fees of the prevailing party arising from any legal dispute with the BMWCOSC regarding ride activities
I promise to maintain a valid operators license and at least minimal limits of coverage as required by the Vehicle Code of your state of residence for liability and property damage at all times as a reciprocal agreement with other members of the BMWCOSC organization to promote members’ mutual welfare.
I grant BMWCOSC permission to use photos of me and my motorcylce in club promotional materials.

Date: May 19, 2024

Please select who will be joining the club...

Adult Minor(s)
1 Minor 2 Minors 3 Minors 4 Minors 5 Minors More Minors 6 Minors 7 Minors 8 Minors 9 Minors 10 Minors

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First Member's Name

First Name*

Last Name*

Phone*

First Member's Age Acknowledgment*

First Member's Date of Birth*

I certify that I am 18 years of age or older

First Member's Optional Information

Spouse/Partner

Primary Motorcycle Brand and Model

AMA # (if any)

BMWMOA # (if any)

T-shirt Size

Your birthday (month & day)

Membership is for 12 months from time you join, with renewal occurring the first of the next month. For example, if you join on Feb 15, your renewal will be on March 1 of the following year. You will be notified my email when your renewal is due.

First Member's Signature*

Type Signature

Draw Signature

Click to Sign

Second Member's Name

First Name*

Last Name*

Second Member's Date of Birth*

Second Member's Optional Information

Spouse/Partner

Primary Motorcycle Brand and Model

AMA # (if any)

BMWMOA # (if any)

T-shirt Size

Your birthday (month & day)

Third Member's Name

First Name*

Last Name*

Third Member's Date of Birth*

Third Member's Optional Information

Spouse/Partner

Primary Motorcycle Brand and Model

AMA # (if any)

BMWMOA # (if any)

T-shirt Size

Your birthday (month & day)

Fourth Member's Name

First Name*

Last Name*

Fourth Member's Date of Birth*

Fourth Member's Optional Information

Spouse/Partner

Primary Motorcycle Brand and Model

AMA # (if any)

BMWMOA # (if any)

T-shirt Size

Your birthday (month & day)

Fifth Member's Name

First Name*

Last Name*

Fifth Member's Date of Birth*

Fifth Member's Optional Information

Spouse/Partner

Primary Motorcycle Brand and Model

AMA # (if any)

BMWMOA # (if any)

T-shirt Size

Your birthday (month & day)

Sixth Member's Name

First Name*

Last Name*

Sixth Member's Date of Birth*

Sixth Member's Optional Information

Spouse/Partner

Primary Motorcycle Brand and Model

AMA # (if any)

BMWMOA # (if any)

T-shirt Size

Your birthday (month & day)

Seventh Member's Name

First Name*

Last Name*

Seventh Member's Date of Birth*

Seventh Member's Optional Information

Spouse/Partner

Primary Motorcycle Brand and Model

AMA # (if any)

BMWMOA # (if any)

T-shirt Size

Your birthday (month & day)

Eighth Member's Name

First Name*

Last Name*

Eighth Member's Date of Birth*

Eighth Member's Optional Information

Spouse/Partner

Primary Motorcycle Brand and Model

AMA # (if any)

BMWMOA # (if any)

T-shirt Size

Your birthday (month & day)

Ninth Member's Name

First Name*

Last Name*

Ninth Member's Date of Birth*

Ninth Member's Optional Information

Spouse/Partner

Primary Motorcycle Brand and Model

AMA # (if any)

BMWMOA # (if any)

T-shirt Size

Your birthday (month & day)

Tenth Member's Name

First Name*

Last Name*

Tenth Member's Date of Birth*

Tenth Member's Optional Information

Spouse/Partner

Primary Motorcycle Brand and Model

AMA # (if any)

BMWMOA # (if any)

T-shirt Size

Your birthday (month & day)

Member's Address

Address Line 1:*

Street address, P.O. box, company name, c/o

Address Line 2:

Apartment, suite, unit, building, floor, etc.

Country:*

City:*

State/Province:*

Zip/Postal:*

Parent or Guardian's Email Address

A signed copy of this waiver will be sent to the email address you provide.

Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*

How did you hear about the club?

Select one*

through a friend

at a dealership

a web search

on Facebook

other

details if 'other' selected above

Payment Method

I choose to pay via*

PayPal (or Credit Card payment), which will appear after submitting this waiver

I will mail a check to the club - BMW Club of Southern California, 5737 Kanan Road #169, Agoura Hills, CA 91301

Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.

By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.

Parent or Guardian's Name

First Name*

Last Name*

Phone*

Parent or Guardian's Age Acknowledgment*

Parent or Guardian's Date of Birth*

I certify that I am 18 years of age or older

Parent or Guardian's Optional Information

Spouse/Partner

Primary Motorcycle Brand and Model

AMA # (if any)

BMWMOA # (if any)

T-shirt Size

Your birthday (month & day)

Parent or Guardian's Signature*

Type Signature

Draw Signature

Click to Sign

Electronic Signature Consent*

By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.

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