Essex Chapter GB

Membership Form

Enter your details and click "Submit".
Please note, a * denotes required fields.

Solo Membership £24 - Joint membership £30

New Membership/Renewal *
First Member Name *
Date of birth (DD/MM/YYYY)
 
Joint Member Name (If applicable)
Date of birth (DD/MM/YYYY)
 
Address
Post Code *
 
Home phone number
Mobile phone number
 
Full member eMail Address *
Joint member eMail Address
 
Harley Davidson or Buell Model
Bike Registration Number
 

Essex Chapter is a group of Harley Davidson motorbike owners and enthusiasts. Please read this declaration, the disclaimers, and code of conduct before signing.

Declaration

I accept that the information contained on this application form will be stored on a computer database. The nominated Chapter membership secretary will maintain the database. The information contained is for Essex Chapter use only, and will not be used for any purpose other than normal Chapter business. The information will not be transmitted to any third party outside of the Chapter.

Ride Disclaimer

Essex Chapter Great Britain (referred to as the Chapter), its directors, officers and representatives accept no legal liability for accident, injury, loss or damage incurred whilst riding on an organised Chapter ride out or at any other time. You are responsible for your own safety at all times. Whilst ride leaders or road captains will give you indications of actions to be taken i.e. 2nd rider drop offs, it is and must remain your decision whether and where to stop to ensure both the safety of yourselves and other road users. You are responsible for your own safety at all times. If a road captain feels that your riding represents a danger to you or any other road user you will be asked to leave the ride out - this is not negotiable. All participating riders are responsible for maintaining valid insurance in respect of Third Party loss or damage, valid MOT certificate [where applicable] and to ride within all statutory laws and regulations applicable under the relevant Road Traffic Act

Disclaimer

Essex Chapter is an independent entity responsible for its actions. All members and their guest[s] participate voluntarily and at their own risk in Chapter activities. All Chapter Officers are and shall be released and held harmless by the member/guest for any injury or loss to the member/guest or to his or her property which may result from participation in Chapter activities. This means that each and every member of the Chapter and their guest[s] have no grounds for legal action against the Chapter, its Officers and their respective agents and employees for any injury resulting to them or their property.

Code of Conduct

  • Treat everyone with respect
  • Treat each member as you wish to be treated yourself
  • Be tolerant
  • Respect the beliefs and views of others even when not in line with yours
  • Honour the Chapter Charter and By-Laws

Newsletters, ride-out updates, and other information is generally provided by email or on the website.
Membership Type *
NOTE: Pro Rata Fees for New Members only (Must not have been a member within the last two membership years) Join After July 1st £18 Single/£22 Joint, after Nov 1st includes time up to Jan 31st + following years membership at full subscription fee. By submitting this application form I certify that I have read the above declaration, disclaimers, and code of conduct and fully understand and agree with them and I am not relying on any statements or representations made by Chapter Officers.
 
Please make Cheques payable to: Essex Chapter and send the cheque to:
Essex Chapter Membership
Unit 7 Han House Harvey Road, Basildon, Essex SS13 1EP
or
BACs Details: Sort Code: 30-92-93 A/c No: 70331768 Ref: Your Name or Membership No.
 
Payment Method *
 
Riding History
 
Please can you provide a few details about your riding history        
 
How long have you been riding?
How long have you owned a Harley?
Have you ridden in a group, large or small
Voluntary Questionnaire
 
To assist the Chapter with continuous improvement, future planning and Admin please provide the following information
 
Where/How did you find out about usWhat appeals to you about the chapter
Web SearchAlready know member/s
ForumDiversity/No. of events/year
EventPrevious member (HOG)
Social MediaAttending a chapter event
RecommendationSocial Events
Word of mouthTours/Rideouts
DealershipOther - please specify below
Other - please specify below
  
If you can read this, don't touch the following text fields.