LRSM

FORM FEES: 150 INR

This club has been made exclusively for riding on the following four brands.

Royal Enfield Harley Davidson Indian Motorcycle Triumph

Personal Details

FIRST NAME

BLOOD GROUP

MIDDLE NAME

ANY MEDICAL CONDITION OR ALLERGIES

LAST NAME

NICK NAME

DRIVING LICENCE NO

DOB

EXPIRY DATE

GENDER

MALE FEMALE

PERMANENT ADDRESS

FATHER FIRST NAME

If Your Permanent Address & Present Address same

Present Address

FATHER MIDDLE NAME

UPLOAD LICENCE

NATIONALITY

UPLOAD ID Prove/Image

FATHER LAST NAME

PROFILE IMAGE

MOBILE NO

PHONE NO

Emergency Contact

NAME

RELATION

CONTACT

Spouse Details (Optional, incase wishes to ride)

FIRST NAME

BLOOD GROUP

MIDDLE NAME

ANY MEDICAL CONDITION OR ALLERGIES

LAST NAME

NICK NAME

DRIVING LICENCE No

DOB

EXPIRY DATE

GENDER

MALE FEMALE

PERMANENT ADDRESS

FATHER FIRST NAME

If Your Permanent Address & Present Address same

MIDDLE NAME

Present Address

LAST NAME

NATIONALITY

MOBILE

PHONE

Referred By (Optional)

How did you come to know about us?

MEMBER ID

NAME

I AGREE TO TERMS AND CONDITIONS

I AGREE TODECLARATION

FORM FEES: 150 INR

This club has been made exclusively for riding on the following four brands.

Membership Type (select one)

Personal Details

Emergency Contact

Spouse Details (Optional, incase wishes to ride)

Referred By (Optional)