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BMW Club of Southern California

BMWCOSC

Existing Member Renewal

To remain a member of the BMW (Motorcycle) Club of Southern California, please fill out the information below and sign the acknowledgment. Your renewal fee can be paid online via PayPal at the end of this 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 renewal 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 the BMWCOSC approval to use photos of me and my motorcylce in the club's promotional materials

Date: May 19, 2024 

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 Information Updates (OPTIONAL)
My info has not changed

Spouse/Partner

Primary Motorcycle Brand and Model

AMA # (if any)

BMWMOA # (if any)

NEW: Your birthday (month & day)
First Member's Signature*
Second Member's Name

First Name*

Last Name*
Second Member's Date of Birth*
Second Member's Information Updates (OPTIONAL)
My info has not changed

Spouse/Partner

Primary Motorcycle Brand and Model

AMA # (if any)

BMWMOA # (if any)

NEW: Your birthday (month & day)
Third Member's Name

First Name*

Last Name*
Third Member's Date of Birth*
Third Member's Information Updates (OPTIONAL)
My info has not changed

Spouse/Partner

Primary Motorcycle Brand and Model

AMA # (if any)

BMWMOA # (if any)

NEW: Your birthday (month & day)
Fourth Member's Name

First Name*

Last Name*
Fourth Member's Date of Birth*
Fourth Member's Information Updates (OPTIONAL)
My info has not changed

Spouse/Partner

Primary Motorcycle Brand and Model

AMA # (if any)

BMWMOA # (if any)

NEW: Your birthday (month & day)
Fifth Member's Name

First Name*

Last Name*
Fifth Member's Date of Birth*
Fifth Member's Information Updates (OPTIONAL)
My info has not changed

Spouse/Partner

Primary Motorcycle Brand and Model

AMA # (if any)

BMWMOA # (if any)

NEW: Your birthday (month & day)
Sixth Member's Name

First Name*

Last Name*
Sixth Member's Date of Birth*
Sixth Member's Information Updates (OPTIONAL)
My info has not changed

Spouse/Partner

Primary Motorcycle Brand and Model

AMA # (if any)

BMWMOA # (if any)

NEW: Your birthday (month & day)
Seventh Member's Name

First Name*

Last Name*
Seventh Member's Date of Birth*
Seventh Member's Information Updates (OPTIONAL)
My info has not changed

Spouse/Partner

Primary Motorcycle Brand and Model

AMA # (if any)

BMWMOA # (if any)

NEW: Your birthday (month & day)
Eighth Member's Name

First Name*

Last Name*
Eighth Member's Date of Birth*
Eighth Member's Information Updates (OPTIONAL)
My info has not changed

Spouse/Partner

Primary Motorcycle Brand and Model

AMA # (if any)

BMWMOA # (if any)

NEW: Your birthday (month & day)
Ninth Member's Name

First Name*

Last Name*
Ninth Member's Date of Birth*
Ninth Member's Information Updates (OPTIONAL)
My info has not changed

Spouse/Partner

Primary Motorcycle Brand and Model

AMA # (if any)

BMWMOA # (if any)

NEW: Your birthday (month & day)
Tenth Member's Name

First Name*

Last Name*
Tenth Member's Date of Birth*
Tenth Member's Information Updates (OPTIONAL)
My info has not changed

Spouse/Partner

Primary Motorcycle Brand and Model

AMA # (if any)

BMWMOA # (if any)

NEW: 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

Email
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*
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 Information Updates (OPTIONAL)
My info has not changed

Spouse/Partner

Primary Motorcycle Brand and Model

AMA # (if any)

BMWMOA # (if any)

NEW: Your birthday (month & day)
Parent or Guardian's Signature*
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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