Applicants Details |
Membership Fees | |||||
Club Membership | |||||
Juvenile | Under 16 years old | £5-00 | |||
Junior | 16 & 17 years old and full-time students | £11-00 | |||
Associate | £12-00 | ||||
2nd claim | 50% of above | ||||
FAMILY MEMBERSHIP Please complete a seperate form for each family member. | |||||
British Cycling | |||||
If you
are not a member and wish to join please contact British
Cycling direct. |
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Under 12 | If
already a member, please quote your Membership No ................................. |
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Youth (12-15) | If
already a member, please quote your Membership No ................................. |
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Junior (16-18) | If
already a member, please quote your Membership No ................................. |
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Senior (19+) | If
already a member, please quote your Membership No ................................. |
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Family | If
already a member, please quote your Membership No ................................. |
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Racing Licence | If
already a member, please quote your Membership No ................................. |
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Cycling UK (Cyclists Touring Club) | |||||
Affiliate * | £28-00 | ||||
Full Member | Membership Number ................................. | ||||
* This allows you to take part in Club activities and time-trials, but not road, track, Cyclo-Cross or mountain bike racing where British Cycling membership and either a full or day racing licence is required. | |||||
Total Due |
(cheques payable to Mildenhall CC) |
|
continued
Parental Consent |
To be signed by the parent
or guardian of Club Members under the age of 18.
|
I (Name & Address) | |
being the parent/ guardian of |
Hereby agree to his/ her taking part in the activities of Mildenhall Cycling Club and acknowledge that I have been advised as to the nature of the Clubs activities. | |
In respect to Club Runs, I am aware that whilst Club members will give assistance when an emergency has occurred, neither the Club, nor its members undertake responsibility for instruction or supervision. My son/ daughter must assume full responsibility for his/ her own safety and compliance with the law of the land relating to road travel. I have discussed the situation with my son/ daughter and am satisfied that he/ she is sufficiently responsible and competent to ride in a maner, which is safe for him/ her and others. | |
I agree to my son/ daughter taking part in Club activities at his/ her own risk and without any liability on the part of the Mildenhall Cycling Club, its officials or members in respect of any injury, loss or damage suffered by him/ her however caused. | |
There are occasions when a Club or media photographer/film-crew may be present at the sessions. Please delete Yes or No as required. YES - I agree to my son/daughter being photographed or filmed. I also agree to the use of the resulting images by Mildenhall Cycling Club/media organisations for the purposes of publicity. |
Signed | Date | ||
Club Witness | Date |