Contact details
Name
Postal address
Contact telephone number
Contact email address
About you (this section is optional but it will help us to understand more about our members – information provided by members will be collated and used at a collective level and no individual will be identified as a result)
Are you registered disabled?
Do you have an illness or disability, which requires you to ride an adapted motorcycle or trike?
Do you belong to a motorcycle club?
Do you ride a motorcycle or trike?
Have you had to give up riding due to ill health?
Data Protection
Can we use your details to contact you about news and events from MAD Scotland?
Membership
Registration for founder membership is £50.00, which entitles you to free membership. As part of this, you’ll be sent a membership patch and founder patch free of charge. Subsequent year bars will be available at cost.
I the undersigned agree that I support the aim of MAD Scotland by raising funds directly and through community involvement for freedom of mobility for all disabled persons in Scotland.
Signed	Date