XLCR Club - For enthusiasts, owners, riders and restorers of XLCR motorcycles

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

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.