Rally Registration - BMW Motorcycle Club of Hampton Roads

Pre-registration must be received by October 8^th . On-site registration begins Friday, October 21st at noon. Please fill out one registration form below per motorcycle. EACH adult MUST sign this form. Participation awards are based on the information given in this form, so please complete the ENTIRE form!! Pre-Rally Fees: $80/Adult $25/Child (under 12) At Rally Fees: $90/Adult $30/Child (under 12)

Riders Name:
Gender:
Date of Birth:
MM slash DD slash YYYY
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone
Email*
Passenger's Name:
Gender:
Children:
Ages:
Will you be Tent camping with us?*
Number of nights:
Motorcycle Make:
Motorcycle Model:
Motorcycle Year:
How many miles will you be riding to the Rally?
Local Club Memberships:
Please let us know what local clubs you and or your passenger belong to.

An option to pay via PayPal will be presented upon submission of registration or you may mail a check as indicated below.

To pay by check make payable to BMWMCHR and mail with completed registration forms to:

BMWMCHR Treasurer
3885 Counselor lane
Virginia Beach, VA 23452
treasurer@bmwmchr.com