Application for Membership

Submitted by Robert OKeefe on 22 December 2020 - 11:25am

I hereby apply to join the Maidenhead & District Cycling Club in the category indicated below and agree to abide by the constitution of the Club as laid down in the Rules and Regulations. I understand that I participate in Club activities entirely at my own risk and that no liability whatever shall attach to the Club, its Officials or Members in respect of injury, loss or damage suffered by me, however caused.

Membership of the club is by annual subscription, due on 1 January each year. For new members joining on or after 1 September the full subscription fee applies, but this will cover them for the remaining part of the year, and the following year.

Name: *

Date of Birth: *

Full address including post code: *

Phone number: *

Please enter your preferred contact number.

Email: *

Membership category: *

Available membership categories:

Veteran (65+) (£12.50)

Senior (18-64) (£25.00)

Under17 (16-17) (£12.50)

Under15 (14-15) (£5.00)

Second Claim (£12.50) Please state first claim club

First claim club (if applicable):

Emergency contact name:

Emergency contact number:

The provision of emergency contact information is highly recommended in case of an incident. The data will be held securely by the Membership Secretary and only passed onto committee members with your consent.

Maidenhead & District Cycling Club

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