Applicants Details

 
Full Name      Date of Birth  
Address      
Post Code           Telelphone No
Email          
Former Club (If joining from another Club)     

Signature         Date

Membership Fees
A Club Membership
Juvenile Under 16 years old £5-00
Junior 16 & 17 years old and full-time students £10-00
Senior 18 years old and over £20-00
Over 60 £15-00
Unwaged £10-00
Family Maximum of 2 adults and 3 chlidren
(up to the age of 16 yrs) living in the same household.		 £36-50
Associate £5-00
2nd claim 50% of above
FAMILY MEMBERSHIP Please complete a seperate form for each family member.
B British Cycling (Formerly BCF)
If you are not a member and wish to join please contact British Cycling direct.
Under 12 If already a member,
please quote your Membership No .................................
Youth (12-15) If already a member,
please quote your Membership No .................................
Junior (16-18) If already a member,
please quote your Membership No .................................
Senior (19+) If already a member,
please quote your Membership No .................................
Family If already a member,
please quote your Membership No .................................
Racing Licence If already a member,
please quote your Membership No .................................
C Cyclists Touring Club
Affiliate * £12-00
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)

 

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 or its members undertake responsibility for instruction or supervision and 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.
Signed Date
Club Witness Date