Application for Membership Within The

Military Brotherhood MMC

Application

for

MEMBERSHIP

Please email this form to:

or snail mail to:
Club Secretary, 12 Tanah Merah Ave Tanah Merah 4128 Qld

Name and Residential Details

Surname – / Given names -
Nick name (AKA) – / DOB - / Name of Spouse/Partner -
Your Address - / Home Tel – / E-mail –
Mobile -
Emergency Contact Name – / Relationship to you - / Emergency Contact Telephone –
Emergency Contact Mobile –
Motorcycle Size T-Shirt Size(please tick)
Make of motorcycle – / Engine Capacity - / Rego - / S M L XL XXL

Type of Membership (please read and circle a response)

Do you currently serve or have served in the ADF or CWTH forces? /

YES

NO

IF YES, then you will be applying for Service Membership. Note, a minimum of an open motorcycle licence is required, with a pledge to obtaining a motorcycle of the correct capacity.

IF NO, then you will be applying for Sierra Squad Membership.

Service History(Circle the relevant response)

Army / Navy / Air Force / Other / Type of Service completed- / P/T / F/T
Service #/PMKeys # - / Rank - / Corp/Muster -
Date of Enlistment– / Date of Discharge -
Current Posting (if applicable) –
Operational deployments – / Honours and Awards –
Medical (for First Aid/Ambulance Treatment)
Blood Group - / What Disability(s)? –
What Medical Condition do you have? – / What Medication are you taking? –
What Allergy(s) if any?–
Previous Motorcycle Club Membership(Circle the relevant response)
Have you ever been involved with another motorcycle club?
If YES, which Club? / YES / NO
Have you ever been involved with a Declared Criminal Organisation?
If YES, which organisation? / YES / NO
Consent for phone number to be on Club website. / YES / NO

IMPORTANT INFORMATION FOR PROSPECTIVE MEMBERS

Consent and Release Declaration

I hereby provide my signature as Consent and written authorisation for my military service to be checked (as detailed on Page 1) for authenticity through the Dept of Defence Central Records against the honours and awards I have claimed.

I hereby agree to abide by the Military BrotherhoodMMCConstitution and By Laws (SOPs).

I also declare that I agree with the Release Provisions as follows:

In joining as a Club member, I agree that the Club and its Sub Branches and their respective officers (herein called “RELEASED PARTIES”), shall, to the extent permitted by law, not be liable or responsible for injury, paralysis or death to me or loss or damage to my property arising from or in connection with any Club activities described as “Rides”, “Poker Runs”, “Rallies”, “Field Meets”, “Overnight runs” (herein termed “EVENTS”). This declaration includes any acts or omissions occurring during the performance of the duties of the “RELEASED PARTIES”, even where the damage, loss or injury is caused by negligence (except wilful neglect).
I understand and agree that all Club and Sub Branches members and their guests participate voluntarily and at their own risk in all “EVENT(s)” and I assume all risks of injury and damage arising out of the conduct of such “EVENT(s)”. I waive, release, discharge and hold the “RELEASED PARTIES” harmless from and against any and all injury, loss or damage to my person or property, and from and against any and all claims, demands, rights, losses (including loss of profits), damages, costs or expenses (including legal fees and costs of investigation), liabilities or causes of action of any kind whatsoever, which may in any way arise out of or in conjunction with my participation in any “EVENT(s)”.
I UNDERSTAND THAT THIS MEANS THAT I AGREE NOT TO SUE ANY OR ALL OF THE “RELEASED PARTIES” FOR ANY INJURY, LOSS OR DAMAGE TO MYSELF OR MY PROPERTY OR FOR ANY OTHER CLAIMS ARISING FROM, OR IN CONNECTION WITH, THE PERFORMANCE OF THEIR DUTIES IN SPONSORING, PLANNING OR CONDUCTING SAID “EVENT(s)”.
Without limiting the foregoing, and to the extent permitted by law, I agree that the “RELEASED PARTIES” will not be liable to me or to any other person for my or any other person’s death or personal injury arising out of or relating in any way to a breach of warranty implied by section 74 of the Australian Trade Practices Act 1974 (Cwth) in relation to the supply by any of the “RELEASED PARTIES” of recreational services.
By signing these Release Provisions, I certify that I have read the above and that I fully understand their meaning and that I am not relying on any statements or representations made by the “RELEASED PARTIES”.
By signing this indemnity, I hereby declare that all information provided is correct and complete.

I acknowledge that I will be registered as a ‘Probationary’foreither a 6 month probation period(Service Membership) or 3 months probation period(Sierra Squad Membership)and will parade with the Sierra Squad until such time as my application has been accepted by the Executive Committee and I have the relevant capacity motorcycle.

Once accepted as a probationary by the Club, I will pay the application fee of $150 for Service Membership or $75 as a Sierra Squad Member (supporter). This payment must be made within 30 days of my receiving my regalia package and secures my right to receive the following:

For Ex-Service/Current Serving Members (SM) / For Sierra Squad
Members (SS)

MB MMC Breast Patch
AKA Name Patch
Motto patch “The Task is Ours”
MB MMC number plate (once confirmed)
DPCU or DPNU cloth for back of Vest
MB MMC T-Shirt

MB MMC Breast Patch
AKA Name Patch
Motto patch “The Task is Ours”
MB MMC number plate (once confirmed)
MB MMC T-Shirt

I Supply the following items as part of this Application Form:

Tick

Certificate of Service / For Service Members ONLY
Evidence that medals you wear on the left breast were awarded to you
Current Photograph / ALL Members
This Application Form
(Signature and date please) / ALL Members

SIGNATURE …………………………………….. DATE ……………………………...

(Signature and date is required before this application is processed)

CLUB USE ONLY

The person whose name appears on this application form to become a member of the Military Brotherhood MMC, was discussed at the monthly meeting held on the …. / …. / ….

A minimum of 75% or more of Service Members constitutes a quorum for conducting a vote.

A ______% vote in favour was obtained for the person whose name appears on this application form.

WAS ACCEPTED WAS NOT ACCEPTED

A minimum of three Executive member’s signatures is required to validate:

President…………………………………Dated ……………….

Vice President…………………………………Dated ……………….

Secretary…………………………………Dated ……………….

Treasurer…………………………………Dated ……………….

CSM…………………………………Dated ……………….

Quartermaster…………………………………Dated ……………….

Upon finalisation of this application form, the form is to be forwarded to the Club Executive Committee for recording on the National Database and issue of a Club number.

CLUB EXECUTIVE USE -

MEMBERSHIP DATABASE UPDATED……………….

Sub Branch advised YES / NO

Page 1

Updated on 01 November 2013