|
Online Registration
Registration fee is $20 plus $1 credit card convenience fee
per participant.
This form is for registering for the "See the USA with the
AVA" Passport Program.
*Indicates required field.
|
| *Rider Name (Full Name): |
|
*Co-Rider Name (Full Name-
if no co-rider, enter "none"): |
|
| *Rider Age: |
|
*Co-Rider Age (enter N/A
if no co-rider): |
|
| *Mailing Address: |
|
| *City: |
|
*State: |
|
| *Zip Code: |
|
*Email Address: |
|
| Note: Your passport(s) will be
mailed to the address above. |
| I/We belong to the following
organization(s), or check here
if you aren't a member of any of the below: |
| AVA
|
VROC
|
COG
|
KawaNOW
|
| Chapter Affiliation with any of
the above are (enter in appropriate field below, leave default value if
no affiliation): |
|
|
|
|
|
Waiver of Liability
Please read the below Waiver, you must accept
this in order to participate.
Minors under the age
of 18
cannot
submit online registrations, Minors must submit a hardcopy registration
with required Parental consent.
Click here for hardcopy form.
If viewing this form in FireFox
browser, it may be necessary to right click in frame above, and then
select "This Frame", then click to "Open Frame in New Window" to
view Waiver of Liability.
|
|
*Rider (Driver) Agrees
(by selecting this button, the Rider certifies
that he/she is 18 years old or older and has read, understands, and
agrees to the above Waiver of Liability):
|
*Co-Rider Agrees
(by selecting this button, the Co-Rider
certifies that he/she is 18 yrs. or older and has read, understands, and
agrees to the above Waiver of Liability):
No Co-Rider:
|