2024 Membership Application

by
  • If using a phone, it’s easier to fill out the form with your phone in landscape orientation.
  • Every field marked with * is required.
  • Complete & submit this application once for each rider.
  • For family memberships, the “primary” family member will provide the payment. No payment is needed for “other” family members.
  • This is a “smart form”. The information entered affects which choices are available later in the form. For example, if a rider’s age is less than 50, they cannot choose a senior class.
  • Pay by credit card or check. In either case follow the instructions in the form.
  • Membership renewal is $35.00 until April 15th ($50.00 after April 15th).
  • Your number plate decal and/or NETA membership renewal sticker will be mailed to you.
  • Questions? Contact NETA Membership.

Rider

Age on January 1st of this year.
“None” if you don’t belong to a club. “Other” if your club is not listed.

Mailing Address

Emergency Contact

Class

Check ‘Yes’ to be removed from competition for the year-end campionship.

Membership Type & Payment Method

Number Plate Decal

Consent / Waiver of Liability

Signature indicates I have read, understand, and agree to this waiver of liability. I agree to hold blameless the NETA, its Board of Directors, members, event organizers/workers, and/or property owners, for any and all damages to my property and/or injuries (including death) to myself or my child/legal ward while participating in any NETA sanctioned/sponsored event. I assume full responsibility, both legal and monetary, for any and all injuries/damages to any person/property that results from my actions or the actions of my child or legal ward while participating in any NETA sanctioned/sponsored events. I understand that motorcycle events are inherently dangerous and hereby agree to comply with all aspects of the NETA Rulebook with special regard to safety issues.
Clear Signature

Payment

$0.00