WREKINSPORT CYCLING CLUB
Membership Application Form 2008
I wish to apply for membership to Wrekinsport Cycling Club as:
1st Claim - £8
2nd Claim - £8
Junior (16-18 years) - £5
Juvenile (Under 16) - £3
Family Membership - £12
Name(s)
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Address
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Postcode
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Date of Birth
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Tele No.
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E-Mail
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Other contact name and number in case of emergency
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I agree to abide by the rules of the club
Signed
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I understand that all applications for membership are subject to approval by the Club Committee.
FOR APPLICANTS UNDER THE AGE OF 18
I agree to my son/daughter taking part in the Club activities at his/her own risk, without any liability what so ever on the part of the Club, its officials or members, in respect of any injury, loss or damage suffered by him/her, however caused.
Signed (Parent/Guardian)………………………………………………………...
Please return this form to:
Mr Dave Poulter
32 Sunbury Drive
Trench
Telford
TF2 7EA