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Repented Motorcycle Ministry Application
Thank you for your interest in Repented M/M. Please answer all the questions and a Repented Patch Holder will contact you within the next week.
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Email
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Your email
Your Brothers are waiting!
Today’s Date
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MM
/
DD
/
YYYY
FULL Address With City/State/Zip/Country
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Your answer
Cell Phone Number
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Your answer
Legal Name (First, Middle, Last)
Your answer
Emergency Contact, Relationship, and Contact Number
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Your answer
How did you hear about us?
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Your answer
Do you have any MC or Riding Club experience? Please explain.
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Your answer
Your Facebook Account Name
Your answer
What church do you attend? (include city and state)
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Your answer
What type of ministries are you currently involved in?
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Your answer
What type of Motorcycle do you have and how many CC's?
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Your answer
Do you own it?
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Your answer
Occupation
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Your answer
How long have you been riding?
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Your answer
Are you associated with Law Enforcement? (We minister to Outlaws)
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Your answer
Do you understand and agree that Repented Motorcycle Ministry and our affiliates are not responsible for any injuries you may incur while riding with Repented M/M?
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Your answer
Do you understand and agree that all member gear and our logo is property of Repented M/M and shall be returned in the event of departure?
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Your answer
Would you please consider making a donation to
repentedmm.org
when you finish this application to support our ministry?
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Your answer
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