Blue Knights – Massachusetts I TOY RIDE

(All participants must be registered)

Personal Information

NAME (S):_______________________________________

Street:___________________________________________

City:__________________ State:_____ ZIP______

Email:___________________________________________

(Email requested strictly for notification of future events. We will not share or sell this information.)

Demographic Information (for Awards)

Other Club/Organization? __________________________ Rider�� Passenger�

Distance Traveled to Today’s Ride? _________________

Welcome! – Ride Safely!

This form submitted for: Rider Rider & Passenger

No

Sex Male Male

Blue Knight? Yes - Chapter _____________

�Female Female

Birthdate? ___________ ___________

Registration Form (Fill Out, Print and Bring to the Ride)