* {{JFRFIRSTNAME}}
* {{JFRLASTNAME}}
* {{JFRADDRESS}}
* {{JFRCITY}}
* {{JFRSTATE}}
* {{JFRZIP}}
* {{JFREMAIL}}
* {{JFRPHONE}}
* {{JFRBIRTHDATE}} {{birthDateMonth}} {{birthDateDay}} {{birthDateYear}}
{{Sex0}}
{{Adult1BikeMake36}} {{Adult1BikeYear37}} {{Adult1LicenseType38}}

Please select the magazine of your choice - the first magazine is free, the second magazine is $15/year, a substantial reduction from Newsstand price. Note that the third magazine, Traction e-Magazine is also included free.

Magazine: {{Magazine40_0}}
Magazine: {{Magazine30_0}}
Free Magazine: {{Magazine550_0}}

{{MembershipType}}
Additional adult family members (aged 16 and over) are $85, Children are $5 each.
{{Adult2Role8}}
{{Adult2Name9}}
{{Adult2BikeMake39}} {{Adult2BikeYear40}} {{Adult2LicenseType41}}
{{Adult2Age56}}
{{Adult2Email57}}
{{Adult3Role12}}
{{Adult3Name13}}
{{Adult3BikeMake42}} {{Adult3BikeYear43}} {{Adult3LicenseType44}}
{{Adult3Age58}}
{{Adult3Email59}}
{{Child1Role16}}
{{Child1Name17}}
{{Child1BikeMake45}} {{Child1BikeYear46}} {{Child1LicenseType47}}
{{Child1Age60}}
{{Child1Email61}}
{{Child2Role20}}
{{Child2Name21}}
{{Child2BikeMake48}} {{Child2BikeYear49}} {{Child2LicenseType50}}
{{Child2Age62}}
{{Child2Email63}}
{{Child3Role24}}
{{Child3Name25}}
{{Child3BikeMake51}} {{Child3BikeYear52}} {{Child3LicenseType53}}
{{Child3Age64}}
{{Child3Email65}}

* {{PrimaryClubName28}}
{{SecondaryClubName30}}
{{SecondaryClubName32}}
 


Fee Breakdown

Member 1 Fee {{Adult1Fee1}}
Member 2 Fee {{Adult2Fee7}}
Member 3 Fee {{Adult3Fee11}}
Member 4 Fee {{Child1Fee15}}
Member 5 Fee {{Child2Fee19}}
Member 6 Fee {{Child3Fee23}}
Primary Club Fee {{PrimaryClubFee29}}
Additional Club Fee {{SecondaryClubFee31}}
Additional Club Fee {{SecondaryClubFee33}}
Additional Magazine Fee {{SecondMagazineFee5}}
Taxable Subtotal {{TaxableSubtotal67}}{{SUBTOTAL}}
H.S.T. Collected {{Tax69}}{{HSTCollected54}}
Tax Exempt Subtotal {{TaxExemptSubtotal68}}
Total Collected {{Total70}}{{TOTAL}}