*	First Name:
*	Last Name:
*	Address:
*	City:
*	Province:
*	Postal Code:
*	Email Address:
*	Phone:
*	Birthday:
	Sex
	Bike (Make/Year/Plate)

	Magazine:	Inside Motocross & Offroad ($0.00)
	Magazine:	Inside Motorcycles ($15)

	Include My Family?	Yes

	Adult 2 Role
	Adult 2 Name
	Adult 2 Bike (Make/Year/Plate)
	Adult 3 Role
	Adult 3 Name
	Adult 3 Bike (Make/Year/Plate)
	Child 1 Role
	Child 1 Name
	Child 1 Bike (Make/Year/Plate)
	Child 2 Role
	Child 2 Name
	Child 2 Bike (Make/Year/Plate)
	Child 3 Role
	Child 3 Name
	Child 3 Bike (Make/Year/Plate)


*	Primary Club Name
	Secondary Club Name
	Secondary Club Name

	Sub-Total:
	HST
	Total: