Midwest Krawlers

2025 Member Registration

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2025 Member Registration

Registration for new and returning full (voting) members for the 2025 year.

Are you a new or returning (renewing from 2024) member?(Required)

Please choose one.

I am a returning member.

I am a new member.

Membership Type(Required)

Birthday

This is completely optional, but we would love to send you a greeting on your special day! If you would rather not disclose your entire birthdate, leave the year as 9999.

Month

Day

Year

Name(Required)

First Last

Primary Phone Number(Required)

Please enter your primary phone number (including area code).

Email Address(Required)

Please enter and confirm your email address.

Enter Email Confirm Email

Age(Required)

Persons under the age of 18 may be registered as Jr. Krawlers, with a sponsoring adult member.

Yes, I am at least 18 years old

I would like to receive e-mail updates regarding club business and events.(Required)

Yes

No

I would like to receive text updates regarding club business and events.(Required)

message and data rates may apply

Yes

No

Address(Required)

Street Address Address Line 2 City State ZIP Code

Emergency Contact Name(Required)

Who should we contact in the event of an emergency? Please include first and last name.

First Last

Emergency Contact Phone(Required)

Please enter the primary phone number of your emergency contact.

Shirt Size(Required)

Please select a shirt size below.

How do you want to receive your membership SWAG?(Required)

Please select an option.

Pick up at February club meeting

Mail to me after February club meeting

Make/Model(Required)

Tell us a little about your rig.

If "other," enter it here.

How did you hear about us?(Required)

Social Media

Google Search/Club Website

Past/Current Member

Other

Referring Member's Name

Please enter the first and last name of the club member who referred you!

First Last

I have read the By-Laws(Required)

I have read and will abide by the By-Laws

I have read the Code of Conduct(Required)

I have read and will abide by the Code of Conduct

I have read the Liability Release(Required)

I have read and accept the Liability Release

2025 Member Registration(Required)

Price:

Total

Credit Card(Required)

Cardholder Name

Card Details

Comments

This field is for validation purposes and should be left unchanged.

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