CANADIAN MOTORCYCLE CRUISERS Registration Form<form method="post" action="http://www.emailmeform.com/fid.php?formid=151433" enctype="multipart/form-data" accept-charset="UTF-8">
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<font face="Verdana" size="2" color="#000000">By submitting this form, you agree to the bylaws and code of conduct of the Canadian Motorcycle Cruisers as defined on our National webpage.  3 main rules: No alcohol on group rides, ride safely and always be cordial.  

CANADIAN MOTORCYCLE CRUISERS Registration</font>
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 <td><font face="Verdana" size="2" color="#000000">Your Name (First and Last)/Votre Nom </font></td>
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 <td><font face="Verdana" size="2" color="#000000">Your Email Address/Adresse de courriel </font></td>
 <td><input type="text" name="FieldData1" size="30"> </td>
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 <td><font face="Verdana" size="2" color="#000000">Confirm your email </font></td>
 <td><input type="text" name="FieldData2" size="30"> </td>
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 <td><font face="Verdana" size="2" color="#000000">Address </font></td>
 <td><input type="text" name="FieldData3" size="30"> </td>
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 <td><font face="Verdana" size="2" color="#000000">City/Ville & Province </font></td>
 <td><input type="text" name="FieldData4" size="30"> </td>
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 <td><font face="Verdana" size="2" color="#000000">Postal Code/Code Postal </font></td>
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 <td><font face="Verdana" size="2" color="#000000">Home Phone </font></td>
 <td><input type="text" name="FieldData6" size="30"> </td>
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 <td><font face="Verdana" size="2" color="#000000">Cell Phone/Cellulaire </font></td>
 <td><input type="text" name="FieldData7" size="30"> </td>
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 <td><font face="Verdana" size="2" color="#000000">How did you find us/Comment nous avez-vous <br />
trouv�? </font></td>
 <td><input type="text" name="FieldData8" size="30"> </td>
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 <td><font face="Verdana" size="2" color="#000000">What is your bike/Type de v�los </font></td>
 <td><input type="text" name="FieldData9" size="30"> </td>
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 <td><font face="Verdana" size="2" color="#000000">What is your nic-name/Quel est votre nic-nom? </font></td>
 <td><input type="text" name="FieldData10" size="30"> </td>
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 <td><font face="Verdana" size="2" color="#000000">What Chapter would you like to join?/Qu'est-ce <br />
que le chapitre voulez-vous participer? </font></td>
 <td><input type="text" name="FieldData11" size="30"> </td>
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<td id="captcha_table_header_td"class="label" colspan="2"><font color="#FFFFFF" face="Verdana" size="2"><b>Image Verification</b></font></td>
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<td id="captcha_table_img_td" class="captcha" style="padding: 2px;" width="10"><img src="http://www.emailmeform.com/turing.php" id="captcha" alt="captcha"></td>
<td class="field" valign="top"><div><font color="#000000">Please enter the text from the image</font>:<br><input type="text" name="Turing" value="" maxlength="100" size="10">
 [ <a href="#" onclick=" document.getElementById('captcha').src = document.getElementById('captcha').src + '?' + (new Date()).getMilliseconds()">Refresh Image</a> ] [ <a href="http://www.emailmeform.com/?v=turing&amp;pt=popup" onClick="window.open('http://www.emailmeform.com/?v=turing&pt=popup','_blank','width=400, height=500, left=' + (screen.width-450) + ', top=100');return false;">What's This?</a> ]</div>
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<input type="text" name="hida2" value="" maxlength="100" size="3" style="display : none;">
<input type="submit" class="btn" value="Join CMC Now" name="Submit">&nbsp; &nbsp; <input type="reset" class="btn" value="  Oops Start Over  " name="Clear"></td>
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</form>CMC (Canadian Motorcycle Cruisers)