Membership form (single)

There are several ways to pay your subscription: if you want to pay by cheque then please use the paper form and post it to us. You should use this form for electronic PayPal or credit card payments ONLY. There are two components to this electronic form, the form itself and your payment. You fill in the form below, then pay your subscription using PayPal or credit card. When we assess your application, we will match up both components so please make sure that you’ve completed both.

    A VALID H.O.G.® MEMBERSHIP IS REQUIRED FOR ALL MEMBERS OF THE GEORDIE CHAPTER. All applications are reviewed and completion of this form does not guarantee acceptance into Geordie Chapter. Membership fees for 2022/23 are £20.00 for a Single Membership or £30.00 for a Joint Membership (two H.O.G. members living at the same address). The membership year runs from 1 March 2022 to 28 February 2023. You can apply for membership for 2022 from 1 December 2021.

    Please collect your Geordie Chapter membership card from our Membership Officer or at a Chapter meeting. We do not mail them out.

    You MUST fill in all the following boxes to allow your application to be processed. If you want to leave a box blank, use N/A. We may check with you to make sure this entry is valid.

    Single member information

    First name

    Surname

    Address (line 1)

    Address (line 2)

    Address (line 3)

    Postcode

    Mobile number

    Email address

    Email address used for Paypal payments

    H.O.G. number

    H.O.G. expiry (DD/MM/YY)


    Declaration:

    You MUST check all four following boxes ...

    I have read the Annual Charter for H.O.G. Chapters and hereby agree to abide by it as a member of this H.O.G. supported Chapter

    I have read the By-Laws for the Geordie Chapter and hereby agree to abide by them as a member of this H.O.G. supported Chapter

    I confirm that I have read and understood the Geordie Chapter Privacy Policy

    I recognise that while this Chapter is chartered with H.O.G., it remains a separate, independent entity solely responsible for its own actions


    This is a release, you MUST read this before submitting this form:

    I agree that the Sponsoring Dealer, Harley Owners Group (H.O.G.), H.O.G. Chapter Officers, Harley-Davidson, Inc., Harley-Davidson Motor Company, Harley-Davidson Europe, Ltd, and any of its corporate affiliates, and their respective officers, directors, employees and agents (hereinafter, the RELEASED PARTIES) shall not be liable or responsible for damage to my property occurring during any H.O.G. or H.O.G. Chapter activities and resulting from acts or omissions occurring during the performance of the duties of the RELEASED PARTIES, even where the damage is caused by negligence (except wilful intent). I understand and agree that all H.O.G. members and their guests participate voluntarily and at their own risk in all H.O.G. activities and I assume all risks arising out of the conduct of such activities. I release and hold the RELEASED PARTIES harmless from any loss to my property which may result from my participation in H.O.G. activities and event(s).

    I UNDERSTAND THAT THIS MEANS THAT I AGREE NOT TO SUE THE RELEASED PARTIES FOR ANY DAMAGE TO MY PROPERTY ARISING FROM, OR IN CONNECTION WITH, THE PERFORMANCE OF THEIR CHAPTER DUTIES IN SPONSORING, PLANNING OR CONDUCTING SAID EVENT(S), EXCEPT IN THE CASE OF WILFUL INTENT BY THE RELEASED PARTIES.

    Nothing in this disclaimer is intended to release any party mentioned herein for any liability for injury or death caused through that party’s negligence. I understand that the RELEASED PARTIES may take photographs of participants at the EVENT(S) for use in H.O.G. related materials. I hereby confirm that I have no objection that my photograph is taken and used in this context and for this purpose. By signing this Release and Authorisation to Photograph, I certify that I have read this Release and fully understand it and that I am not relying on any statements or representations made by the RELEASED PARTIES. By signing this Release, I agree to receive emails and texts from the RELEASED PARTIES.

    Privacy statement: Geordie Chapter operates under the H.O.G. Chapter Charter and we take your privacy seriously. If you provide information to us, we will use it to provide you a membership service, as described in the H.O.G. Chapter Charter, and our Privacy Policy. We will not transfer your personal information to any other party. You can find the H.O.G. Chapter Charter and our Privacy Policy on our website, geordiehog.com. Geordie Chapter will keep your personal information safe and secure. If you have any questions, please email us: privacy@geordiehog.com.


    Now, type your full name in the box below. This is your signature agreeing to the above statements.

    Full name

    Today's date (DD/MM/YY)

    Finally, press send.

     

    Once you’ve submitted the form, you’ll need to pay. Click on the item below to do that, then check out as normal.

    Geordie Chapter membership (single)
    Geordie Chapter membership (single)
    Geordie Chapter membership (single)
    £20.00

    We’ll check the membership details and the PayPal amount, so make sure everything lines up! We’ll let you know when your application has been approved, using the email address provided above.