Road 2 Recovery Membership Application
This Order Form is Secure
Personal Information
First Name MI
Last Name
Address
City
State/Province
Country
Zip/Postal Code
Email
Home Phone
Cell Phone
Gender Male Female
Date of Birth format dd/mm/yyyy

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Membership Options
1 Year Membership- $25 (Includes all benefits listed below)
Pro MX/SX Rider membership 1 Year - $35 (Includes all benefits listed below including catastrophic insurance. )
Pro MX/SX Rider Founding membership Lifetime - $1000 (Includes all benefits listed below including catastrophic insurance. Lifetime Membership)
 
Membership Benefits:
  • Road 2 Recovery Stickers
  • One free pit pass to all SX races
  • $5 discount off SX tickets (purchased on-line only) up to 4 tickets per event
  • 20% Discount at the road 2 recovery on-line store
  • Free $20 gift card from Decal Works with each membership
Credit Card Information
 Card Type
 Name on Card
 Card Number
 Expiration Date
 CVV Number (3 or 4 digit security code)
Your new membership card will be mailed in 3-4 weeks. Thanks for supporting the Road 2 Recovery, a 501(c)(3) non-profit organization dedicated to helping AMA licensed MX/SX members with financial assistance if they sustain career-ending injuries, as well as providing motivational, emotional, and spirtitual support to the individuals and their families.
The Road 2 Recovery Foundation is recognized by the U.S. Government as a not-for-profit charity foundation that meets the 501c-3 requirements.
Our charitable tax ID number is: 86-0996104