2012 CLUB MEMBERSHIP

APPLICATION FORM

 

Name 1…………………………………………..………   Date of Birth………….……….

 

Name 2…………………………………………..………   Date of Birth……….………….

 

Name 3…………………………………………..………   Date of Birth……….………….

 

Address………………………………………….

 

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Post Code………………………...

 

Phone ……………………………………..

 

Email ………………………….…………..

 

Parents / Guardians Names

 

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Parents / Guardians Occupation

 

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Annual Membership Fees           Single Member - £12-00                Family—£20-00

(Family Membership includes 2 or more riders)

I/My* Son/Daughter* wish to become members of the Royston Rockets BMX Racing Club and understand and agree that;

·          I/they* participate in events promoted by the club or other recognised BMX organisation entirely at my/his/her* own risk.

·          the club, it's servants, agents, or employees are not under any liability whatsoever for loss of property, accidents or injuries to me/him/her* however caused.

·          I/they understand the nature of BMX racing and are sufficiently responsible and competent to assume full and entire responsibility for my/their* and other riders safety whilst competing or practicing.

I confirm that I/my Son/Daughter* do not have any disability or medical condition, physical or mental, which could affect my/his/her* ability to ride safely as a racing cyclist. I understand that I must notify the Club Membership Secretary at once if any time I/they* become subject to disability or medical condition, which could affect my/their* ability to ride safely

Applicants Signature        __________________________   Date  ____________

Parent/Guardian must countersign this form if the applicant is under 18 years of age.

 Parent/Guardian

 Signature                     ________________________________  Date  ____________

This form is not an application for British Cycling Membership or BMX Racing Licence. Please complete the separate BC Membership and Licence Application Form and return it with the relevant fees to BC.

You will not be covered by BC insurance unless you hold valid membership and you will not be able to race in The East Anglia Regional Series. For National Series Events you must hold a valid BC Licence.

FOR CLUB USE ONLY.

 

Fee Received ..…....................         Date .…………………........      Club Membership Number .......…..........          

Please return your completed Membership Application form and appropriate fees to the Membership Secretary at the above address or during a club event. Please make cheques payable to Royston BMX Club.

Would  Parents / Guardians be wiling to help with any of the following activities:

Track Maintenance  []     Club Event Administration  []    Race Days  []      Promotion Events   []