Arkansas Freedom Fund
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Warriors who want to  join the AFF. This is the info we need to assist you, The Veterans of Arkansas. Upon completing this application you will be entered into our database. You will receive a welcome email if electronically submitted. All we need is a couple forms and a copy of your DD Form 214 or proof of service. If you choose not to submit your application online you can MAIL, OR FAX IT to us (instructions at the bottom of page).
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Join a program & tell us as much as you can so we can help meet your goals. Use this form also to update your info if you have moved or changed your info to stay up to date.



APPLICATION for MEMBERSHIP

To Join the Arkansas Freedom Fund (AFF) you must fill out the information below and submit your proof of service documents.

    WAIVER & PERMISSION FORM 

    ​Section 1
    ​In consideration of me and/or my child, spouse or ward's participation in any way in any Arkansas Freedom Fund, Inc. program, event, or related activity (collectively, the "Event"), wherever the Event may occur, I agree to assume the risks incidental to such participation (which risks may include, among other things, muscle injuries and broken bones).
    Section 2
    I acknowledge that, if present at the Event, I have or will inspect the facilities and equipment to be used in conjunction with the Event and, if I believe any unsafe condition exists, I will immediately advise an Event official of such condition and will refuse participation until such condition is corrected.
    Section 3
    On my own and/or my child, spouse or ward's behalf, and on behalf of my and/or my child, spouse or ward's heirs, executors, administrators, and next of kind, I hereby release, covenant not to sue, and forever discharge the Released Parties (as defined below) of and from all liabilities, claims, actions, damages, costs or expenses of any nature arising out of or in any way connected with me and my child, spouse, or ward's participation in the Event and/or any such activities, and further agree to indemnify and hold each of the Released Parties harmless from and against any and all such liabilities, claims, actions, damages, costs, or expenses, including, but not limited to, all attorneys' fees and disbursements up through and including any appeal.
    Section 4
    I understand that this release and indemnity includes any claims based on the negligence, action or inaction of any of the Released Parties and covers bodily injury (including death), property damage, and loss by theft or otherwise, whether suffered by me or my child, spouse or ward either before, during or after such participation.
    Section 5
    I declare that I and (if participating) my child, spouse or ward are physically fit and have the skill level required to participate in the Event and/or any such activities. I further authorize medical treatment for myself and/or my child, spouse or ward, at my cost, if the need arises. I also understand that my child, spouse or ward or I may be required to leave the Event venue should my child, spouse or ward or I exhibit undesirable conduct. For the purposes hereof, the "Released Parties" are the Arkansas Freedom Fund, Inc. (AFF Inc.), and its parent, subsidiary, affiliated or related companies; all Event sponsors or charities, and each of their respective parent, subsidiary, affiliated or related companies; and the officers, directors, employees, agents, representatives, successors, assigns and volunteers of each of the foregoing entities.
    Section 6
    I further grant the Released Parties the right to photograph and/or videotape me and/or my child or ward and further to display, use and/or otherwise exploit my and/or my child's, wife's or ward's name, face, likeness, voice, and appearance forever and throughout the world, in all media, whether now known or hereafter devised, throughout the universe in perpetuity (including, without limitation, in on line webcasts, television, motion pictures, films, newspapers, and magazines) and in all forms including, without limitation, digitized images, whether for advertising, publicity, or promotional purposes, or for any other purpose whatsoever, without compensation, reservation or limitation.
    Section 7
    The Released Parties are, however, under no obligation to exercise any rights granted herein. This Waiver and Permission Form shall be governed by the laws of the State of Arkansas, and any legal action related to or arising out of this Waiver and Permission Form shall be commenced exclusively in the State of Arkansas, and I specifically waive the right to trial by jury. I certify that I am 18 years of age or older, that I have read the above Waiver and Permission form in its entirety, and I understand that I have given up substantial rights on behalf of myself, or on behalf of my child, spouse or ward if I am executing this Waiver and Permission Form on behalf of my child, spouse, or ward. 


    * Indicates required field 
    ​Initials of individual over 18 years of age or parent/legal guardian of minor under 18 years of age or legal guardian of incapacitated and/or intellectually disabled person.

    Who is your emergency contact and their relation ship to you.
    ​PLEASE COVER / BLACK-OUT YOUR SSN ON YOUR DD214 it is not needed by the AFF.
    All Veterans we need a copy off your DD-214 or NGR 600-200, and Active-Duty Service Members we need a copy of your orders. Please email a copy to both randy@arkansasfreedomfund.org and rae@arkansasfreedomfund.org .

    PLEASE CHECK ALL YOUR INFORMATION BEFORE SUBMITTING

Submit


STOP here if you completed the online application 


Mail in Application

Just fill out some info below. All of our current members and those wanting to be a part of an AFF event or program. The following forms are required and MUST be received to complete membership. A copy of your DD Form 214 and the two forms below must be completed and returned. Either by email, the connect method below or mailed to:
Email: randy@arkansasfreedomfund.org or rae@arkansasfreedomfund.org  
Mail To:
Arkansas Freedom Fund
PO Box 697
Bryant, AR 72089


Please remember that bikes are not for everybody. It is the responsibility of the Veteran to ensure he secures and cares for a bike. We will not replace lost or stolen bikes. Read the rules on the bike assignment form. We are not a "FREE BIKE" organization, the Veteran must have a desire to enhance a healthy lifestyle through cycling. All bikes are the property of the AFF until one is bought for a Veteran through our Bikes for Troops program. If you arent riding the bike you signed out please return it for another Veteran. You must be an active AFF Member with a submitted DD Form 214 to apply for a bike.

IMPORTANT PLEASE READ IF YOU WANT A BIKE:

We have a relationship with Recycle Bikes for Kids. Located at 717 East 10th St in Little Rock. This is the first step for many to bike ownership. Ron King is the POC at Recycle Bikes and is reachable through their Facebook Page.
Due to the influx of Veterans in many of the special outreach programs, Recycle Bikes for Kids has agreed to help us help you. Veterans needing bikes to begin riding or as a way to get to work or the VA will sign up at the AFF Warriors connect tab on left. We will pass your name to Recycle Bike for Kids. The Veteran will work a minimum of 4 hours at Recycle Bikes. After that the veteran can pick out the bike he wants to get started on. If the Veteran progresses with bike riding and wants to continue riding, the bike goes back to Recycle Bikes and the AFF will upgrade in our normal process.

Download and complete
STEP 1. (AFF FORM 1 Cycling Agreement)
If you DO NOT cycle, skip FORM 1
STEP 2. (AFF FORM 2 WAIVER & PERMISSION FORM)
STEP 3. (AFF FORM 3 Organizational Contact) checklist is at bottom of form.
STEP 4 send in with a copy of your DD Form 214 / NGB22 proof of service.
aff_form_1_cycling_agreement.pdf
File Size: 126 kb
File Type: pdf
Download File

aff_form_2__waiver___permission.pdf
File Size: 91 kb
File Type: pdf
Download File

aff_form_3_organizational_contact_.pdf
File Size: 81 kb
File Type: pdf
Download File

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