Motorcycle Ride for the Veterans - DAYTON NATIONAL CEMETERY HONOR SQUAD

Rider Name (please DO NOT use nickname)

First

Last

City and State

Phone Number

Email (only used for ride reminders)

Will you have a passenger?

No

Yes

Passenger Name (if none, type 'x' in both boxes)

First

Last

Passenger City and State

Passenger Phone Number

Are you a member of a club/association/group?

No

Yes

If yes, name of club/association/group:

How did you hear about this event?

If 'other' was chosen, please tell us how you heard about our event:

Emergency Contact

First Name

Last Name

Emergency Contact Phone Number (only used in case of emergency)

I (We) have read and understand WAIVER & RELEASE OF LIABILITY (see link provided above this form):

No

Yes

Any additional information, comments, or questions our ride committee needs to know?

DAYTON NATIONAL CEMETERY HONOR SQUAD