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XLCR CLUB
REGISTRATION FORM

XLRC Club and Owners Registry
$25/yr

 
INFORMATION   |   MEMBERSHIP   |    REGISTRATION

 
Name:
Address:
City, State, Zip:
Phone:
FAX:
E-Mail:
Type of Bike:
Bike ID#. or Serial#:
OK to publish your information in newsletters?
Yes No
Comments:
  Enclosed is $25 for XLRC Club Newsletter
  Address Change Only
  

For XLCR Club membership, please send payment with self addressed stamped envelope to:

Anthony Long
255 East Easy St. Unit F
Simi Valley, CA 93065

Cashiers checks or money orders only.  
Sorry, we are not currently set up for charge cards.

MAIL: 255 East Easy St. Unit F, Simi Valley CA 93065      |  E-MAIL    |  TEL: 805-218-7960