First Name _________________________________ Last Name ______________________________________

Road or Nick Name __________________________________________________________________________

Address____________________________________________________________________________________

City _______________________________ State _________________________ Zip Code _________________

Phone _______________________________ E-Mail Address _______________________________________

Bike Info Year _____________ Make ____________________Model _______________Color _____________

The INTERNATIONAL STAR RIDERS ASSOCIATION (hereafter known as ISRA), the Dixie Star Riders (hereafter know as DSR), a constellation of the ISRA, including its presence on the Internet in various forms and its constellation (Branches) throughout the world, is not sanctioned by any other organization or individual. The ISRA organization, the DSR constellation, its representatives, office holders, officials, sponsors or any individual member(s) of the ISRA or DSR connected to it in any manner, can never be held liable for, or assume any responsibility for; 1) any person's participation or attendance at any event, ride or meeting held under the auspices of the ISRA or DSR; 2) any property lost, stolen or damaged during such events, rides, or meetings; 3) any physical or mental injury sustained during said events, rides, or meetings; 4) any personal injury or property damage sustained as a direct or indirect result of any alteration of or modification to any motorcycle by any person based on information obtained from the ISRA or DSR. All individuals accept complete responsibility for his/her own self while attending or participating in any event, or in making any alterations or modifications to a motorcycle, with no recourse against the ISRA or DSR or any individual connected in any manner to the ISRA or DSR, or acting as its officer, agent, employee, consignee, vendor or sponsor.

Signature __________________________________________________ Date __________________________

If you are a member of the International Star Riders Association --- Membership number __________________

Print this page, fill it out, bring to a meeting or mail to

Dixie Star Riders
202 Wehunt Road
Monticello, Ga. 31064