Application For Membership

CONTACT NUMBER BELOW FOR MAILING INSTRUCTIONS

PO BOX 1

SHARPES, FL. 32959

PHONE: 321-482-8203 https://devildogsvmcoffla.tripod.com/ (devildogsvmcoffla)

PLEASE ATTACH A COPY OF YOUR DD-214 OR

CERTIFICATE OF DISCHARGE

All information must be completed and returned for approval.

Documentation & dues as outlined below must accompany your application.

PLEASE PRINT CLEARLY

Last Name, First Name, M.I.:________________________________________________

Date of Application:______________________________

Road Name or Nickname (if applicable): ______________________________________

MOS(s):________________________________________________________________

Home Phone: ____________________ Cell Phone: __________________________

Service Number or N/A:_________________ Last Rank Held: _____________________

Month/Year Served: From: _________________To: ______________________

PLEASE SELECT MEMBERSHIP TYPE

MARINE: Active Duty____ Retired____ Honorably Discharged____

FMF CORPSMAN: Active Duty____ Retired____ Honorably Discharged____

SUPPORT: _____

Address: ________________________________________________________________

City: ____________________________ State: _______________ Zip Code: _________

E-Mail Address: _____________________________________

Location of Boot Camp or Officers Candidate School: ____________________________

CORPSMAN COMPLETE THIS SECTION

Hospital Corps School Date and Location: _____________________________________

FMS Date and Location: ___________________________________________________

MOS(s):________________________________________________________________

Last USMC Unit Attached to and Dates: ______________________________________

_______________________________________________________________________

DUES AND SCHEDULE OF RENEWAL

Monthly Dues = $20.00 Colors = $70.00

Support Monthly Dues = $15.00 Colors = $70.00

BACKGROUND QUESTIONAIRE

1. Are you a permanent resident of the State of Florida? Yes____ No____

2. Do you have a motorcycle license issued by the State of Florida? Yes____ No____

3. Do you have and maintain (at least) the minimum coverage motorcycle insurance

required by the State of Florida? Yes____ No____

4. Are you currently or have you ever been a patched member of another motorcycle

club(s) Yes____ No____ If yes, what club(s)________________________________

____________________________________________________________________

Years of Membership___________________________________________________

Circumstances in which you left the club(s) _________________________________

________________________________________________________________________

5. Were you ever a prospect in another motorcycle club? Yes____ No____ If yes,

Why didn’t you patch? __________________________________________________

_____________________________________________________________________

6. Have you ever been convicted of a felony? Yes____ No____ if yes, explain________

_____________________________________________________________________

7. Are you currently under indictment for a felony? Yes____ No____ if yes, explain____

_____________________________________________________________________

8. If you become a member of the Devil Dogs Veterans Motorcycle Club of Florida

will you abide by the bylaws of the organization? Yes____ No____

9. If you become a member of Devil Dogs Veterans Motorcycle Club of Florida, do

you swear to uphold and defend the Constitution and Laws of the United States of

America, and likewise uphold and defend the highest traditions of the United

States Marine Corps? Yes____ No____

BY SIGNING, I ATTEST TO THE TRUTHFULNESS OF MY ANSWERS. I

UNDERSTAND THAT FALSE INFORMATION WILL BECOME CAUSE FOR

IMMEDIATE EXPULSION FROM THE DEVIL DOGS VETERANS MOTORCYLE CLUB

OF FLORIDA. I UNDERSTAND THAT THE COLORS AND ALL OTHER PROPERTY

OF THE DEVIL DOGS VETERANS MOTORCYCLE CLUB OF FLORIDA MUST BE

RETURNED UPON LEAVING THE ORGANIZATION, FOR WHATEVER REASON. A

REFUND WILL BE MADE IF THE PATCHES AND COLORS ARE RETURNED IN

SERVICEABLE CONDITION.

_______________________________________ _________________________

Applicants Signature Date

_______________________________________ _________________________

Witness (Club Officer) Date

Please provide additional information as needed: ________________________________

________________________________________________________________________

Initial Here:

DEVIL DOGS VETERANS MOTORCYCLE CLUB OF

FLORIDA, INC. LIABILITY RELEASE FORM

I agree that the Sponsoring Club, Devil Dogs Veterans Motorcycle Club of Florida, Inc.

(hereinafter “DDVMC”), their respective Club Officers, as well as the sponsoring

individual of any event, property owner of any property that the (DDVMC) has

permission to use, (hereinafter the “Released Parties”), shall not be liable or responsible

for injury to me (including paralysis or death) or damage to my property during any

(DDVMC) activities even where the damage or injury is caused by ordinary negligence.

I understand and agree this release shall be construed in the broadest sense allowed by

law and this is a knowing and intelligent waiver of any and all rights which I might have

to the fullest extent allowed by law. I understand and agree all (DDVMC) members and

guests participate voluntarily and at the individual’s sole risk in all (DDVMC) activities

and hereby knowingly and intelligently agree to assume all risks of injury and damage

arising out of or related to conduct of such activities.

I release, indemnify and hold harmless the “Released Parties” from any injury or loss to

my person which may result from my participation in (DDVMC) activities and events,

and agree to indemnify the “Released Parties” for any cost incurred in defending against

any action I might bring in violation of the terms of this release including, but not

limited to, costs and reasonable attorney fees. I further agree to waive all benefits

flowing for any specific state statue now in effect or subsequently enacted, to the full

extent allowed by law, which would negate or limit the scope of this release and

indemnification agreement.

I hereby understand this means I agree not to sue the “Released Parties” for any injury or

damage to myself or my property resulting from, or in connection with, any (DDVMC)

activities or events.

I represent to the club I have had training and/or experience and I attest I am skilled in

the operation of a motorcycle and riding in a group.

By signing this document I certify I have fully read this Release and completely

understand it. I am not relying on any statements or representations made by the

“Released Parties” and that I knowingly and intelligently execute this release which

shall be effective until revoked in writing by me, prior to any injury, damage or possible

cause of action accruing.

______________________________ _____________________________

Print Name Signature

______________________________

Date