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Music
City Miata Club
Membership Application
New____ Renewal____ Member Since___/___/___
Name___________________________________________________
Spouse, Partner, Other Name________________________________
Address_________________________________________________
City___________________________________State____ Zip ______
Email ___________________________________________________
Home #________________ Work #____________Cell____________
Miata Year____________ Package___________ Color_____________
License Plate Number_______________________________________
Interests (Check all that apply)
__ Autocross __ Car Shows __Co-Club Events __ Cruises
__ Dinners __ Driving Schools __ One-Day Trips __ Overnight Trips
__ Road rallies __ Weekend Trips __ Tech Seminars __ Track Days
Members that organize and lead our activities are event sponsors.
Would you be interested in sponsoring an event? __ Yes __ No
If so, please specify the event, if you have one in mind _______________________________________________________
THE FINE PRINT:
All members and prospective members are informed that the Music City Miata Club, Inc. does not provide medical, accident, or general insurance. By signing this form, you agree to furnish your own liability insurance and you will NOT hold the Music City Miata Club, Inc, its members, or its officers responsible or liable for any accident or injury caused to you or by you, or to your vehicle or another's vehicle; and to comply with Club Rules of the Road and Bylaws.
Annual dues are $25 per family. Make check or money order payable to: Music City Miata Club, Inc. Bring your completed application to our next meeting or mail it with your check or money order to the address below. Prospective memberships will not be processed until the application and the annual membership dues are received.
Music
City Miata Club does not share your information with commercial entities. The Membership list and contact information are shared only with active Club members.
I agree to abide by the terms outlined above.
Signed X______________________________________Date___________
Bring application and check to Monthly Meeting or Mail to:
MCMC Treasurer, 835 Old Highway 31W, Portland, TN
37148
Website:
www.musiccitymiataclub.com
The Club meets the fourth Monday of each month at Piccadilly Cafeteria, 874 Murfreesboro Rd, Nashville, TN, except as indicated on website. |