Print this form by selecting’ print preview’ and ‘print the selected frame’ and send it with your subscription to Michelle Kilcullen, 43 Bramble Road, Stockton-on-Tees TS19 0NH. Cheques payable to Stockton Wheelers C.C.

 

STOCKTON WHEELERS C.C.

 

MEMBERSHIP APPLICATION/ RENEWAL 2010

 

I wish to apply for / renew my /our membership of Stockton Wheelers for 2009, in the following category:

 

  • Junior member (under 18) – £5
  • Senior member (18 and over)  - £10
  • Family- £25 (up to two senior members living at the same address, and their children)
  • Cycling Time Trials handbook £6.50p ( must be ordered with membership before 1st January).

 

All members taking part in club events must be members of British Cycling, the Cyclists’ Touring Club, the British Triathlon Association, or similar organisation and hold third party insurance provided by these organisations. Club membership is invalid if he or she does not hold third party insurance when taking part in a club event. If you will be taking part in club events please provide details below of the organisation which provides you with insurance, your membership number, and date of expiry.

 

Forename

Surname

DoB

Active cyclist Y/N

Organisation BC/CTC/BTA

Membership No

Expiry date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I have read and agree to abide by the Constitution of the Club, (available at www.stocktonwheelers.org.uk). I will be notified of any changes to the Constitution and agree to abide by them or resign my membership.

 

Signed………………………………..

 

Address…………………………………………………………………………………

 

Post Code……………………………..Tel…………………………………………….

 

Email