Please use with Google Chrome or any other modern browser. May not work correctly with Internet Explorer. Membership StartMembership Type New Member RenewalMembership Number PreviousNextRider InformationFirst Name Middle Initial Last Name Street Address Apt or Unit No. City Province Postal Code Email Phone Mobile Health Care Number Birth Date PreviousNextEmergency ContactEmergency Contact Phone Relationship to Rider PreviousNextMotorcycle InformationRequested Race Number1st 2nd 3rd Bike InfoPrimary Make Primary Model Year Secondary Make Secondary Model Year Sponsors PreviousNextMembership FeeMidwest Amateur MX Series & Insurance Price: $60.00No payment items has been selected yet Rider is under 18 years of age. By checking this box, you give your consent for membership.Name of Parent or Guardian Previous Pay with Paypal
