Bert's Mega Mall : RIDER'S CLUB APP

ADD YOUR RIDER'S CLUB LINK NOW! -OR- GET FREE WEB PAGES!
Fill in the information below to get your link on BertsMegaMall.com - OR - If you are part of an official rider's club and need a website you can obtain FREE web pages on Bert's Mega Mall's website to present your Calender of Events, Latest News, Photo Galleries, Video Clips and Contact Info, fill in our application for quick processing.
We will contact you to acquire your photos, clips and info...
It's all a FREE service of bertsmegamall.com!
see a sample site here!
(Limited space available, so apply now!)

*Your Name (first, last):
*Your Chapter Name:
Chapter Locaton:
Website URL:
If you do not have a website address, we can offer you FREE WEB PAGES through BERTSMEGAMALL.COM. Your webpage will look similar to our Bert's Rider's Club - see a sample! This is a limited time offer!
Do You Need Free Web Pages?:	Yes! No Thanks! Just add our link.
Please describe your official riding club! Please be as descriptive as possible!
How Many Members? How Often Do You Meet? Where Do You Meet? Is Your Club Exclusive to a Brand of Cycle, ATV or PWC? Is Your Club Officially Sanctioned?
Rider's Club Contact: Such as a president, or general liason
Contact Phone: (include area code)
*Contact Email Address:
*Contact Email Address:	Privacy Statement: Bert's Mega Mall values the privacy of your personal information and at no time will share your email address with any other company or agency. Your email address will be used soley as a means of communication between Bert's Mega Mall* and yourself. Your email address will not be shared or sold. Your information will be kept strictly confidential.
How should we contact you?