Valley Chapter H.O.G

CHAPTER MEMBERSHIP

ENROLLMENT FORM AND RELEASE

CHAPTER NAME: __________________________________________________

MEMBER NAME: ___________________________________________________
ADDRESS: _________________________________________________________

CITY: _____________________________ STATE: _________    ZIP : ______________

PHONE NUMBER: ________________________ MEMBER H.O.G. NUMBER:_________

EXPIRATION DATE OF H.O.G. MEMBERSHIP: ______________________________

I have read  the Harley Owners Group Charter for local chapters and hereby agree to abide by it as a member of this dealer sponsored local chapter.

I recognize that while my Local Chapter is chartered with H.O.G., it remains a separate, independent entity solely responsible for its actions.

 * THIS IS A RELEASE, READ BEFORE SIGNING *

I agree that the Sponsoring Dealer, Harley Owners Group (H.O.G.), Harley-Davidson, Inc., Harley-Davidson Motor Company, my Local Chapter and their respective officers, directors, employees and agents (hereinafter, the "RELEASED PARTIES") shall not be liable or responsible for injury to me (including paralysis or death) or damage to my property during any H.O.G. or H.O.G. chapter activities, even where the damage or injury is caused by negligence (except willful neglect).  I understand and agree that all H.O.G. members and their guests participate voluntarily and at their own risk in all H.O.G. activities and I assume all risks of injury and damage arising out of the conduct of such activities.  I release and hold the "RELEASED PARTIES" harmless from any injury or loss to my person or property which may result from my participation in H.O.G. activities and EVENT(S).  I UNDERSTAND THAT THIS MEANS THAT I AGREE NOT TO SUE THE "RELEASED PARTIES" FOR ANY INJURY OR DAMAGE TO MYSELF OR MY PROPERTY RESULTING FROM, OR IN CONNECTION WITH, ANY H.O.G. OR H.O.G. CHAPTER ACTIVITIES OR EVENTS.

WAIVER OF RIGHTS UNDER STATE STATUTES

I further agree to waive all benefits flowing from any state statute which would negate or limit the scope of this Release and Indemnification Agreement including, but not limited to, Section 1542 of the California Civil Code which provides:

                        "A general release does not extend to the claims which the creditor does not know or suspect to exist in his

                         favor at the time of executing the release, which if known to him must have materially affected his settlement

                         with the debtor."

By signing this Release, I certify that I have read this Release and fully understand it and that I am not relying on any statements or representations made by the "RELEASED PARTIES".

MEMBER SIGNATURE: __________________________________________________________________

WITNESS: ________________________________________________   DATE: _____________________

LOCAL DUES PAID $ ____10.00 per year_________________________    DATE: _____________________

        (Dues not to exceed maximum amount prescribed in, "Charter for Local Chapters", as contained in the H.O.G. Chapter Handbook.)

RETURN THIS FORM TO YOUR LOCAL CHAPTER WITH YOUR DUES

CLICK HERE for National H.O.G Enrollment/Renewal form