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CAITHNESS CYCLING CLUB |
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MEMBERSHIP FORM |
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2012 |
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Use tab key to navigate through form and fill in details as required
then print and sign. |
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SURNAME |
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FORENAMES |
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ADDRESS |
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TELEPHONE |
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HOME |
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MOBILE |
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E-MAIL |
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DATE OF BIRTH |
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Only if you intend to race. |
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CATEGORY |
TICK |
FEE |
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YOUTH |
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£5 |
12 Years old and those 16 year olds whose 16th birthday |
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falls within the current year. |
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JUNIOR |
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£10 |
Whose 17th or 18th birthday falls within the current year. |
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SENIOR / |
VETERAN |
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£25 |
Veteran 40+ |
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ASSOCIATE |
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£10 |
Full membership is required |
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if you intend to race. |
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FAMILY |
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£30 |
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STUDENT |
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£10 |
UNWAGED |
copy and paste tick |
√ |
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INSURANCE |
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BC or CTC |
Any member wishing to do Time Trials must
have Insurance. |
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Insurance is available by joining British Cycling minimum silver or |
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Full CTC membership please insert which you are a member of. |
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TOTAL |
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Family membership is to include all Youths, Juniors and Parents,
Seniors must take out separate membership. |
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Please enter below other names to be included in family membership
including date of birth if they intend to race. |
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Insert as appropriate BC or CTC. |
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2012 BC MEMBERSHIP FEES. |
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GOLD |
SILVER |
BRONZE |
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Senior £64 |
£36 |
£13.50 |
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Junior £46 |
£24.00 |
£13.50 |
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Youth £34 |
£13.50 |
N/A |
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Note! Bronze Membership dose not |
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include Insurance. |
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CTC MEMBERSHIP FEES 2012 |
Senior £39 Junior £15 |
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I understand that taking part in club events which is held on the
public highway I participate therein entirely at |
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my own risk and that no liability whatever shall attach to the club
or any officials of the club or any member of |
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the club for any injury loss or damage suffered by me in or by
reason of the event however such may be |
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caused and whether by negligence or otherwise. |
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SIGNATURE |
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DATE |
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Persons under the age of 18 years old must have this signed by
Parent/Guardian. |
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