Club Information - Membership Form

REGISTERED YOUTH ORGANISATION AFFILIATED TO: BSCA, BCCA,BCF,CTC, RTTC,YCF,YLCA.				Membership Secretary: Liz Kilgour 52 Lilac Avenue HULL, HU8 8PU 52giant@52giant.karoo.co.uk
Title Mr Mrs Miss   Age Membership Under 16yrs* £5-00 16 to 17yrs* £7-00 18 to 64yrs £12-00 65yrs and over £7-00     Interests Road Racing   Cyclo X Time Trials   Track Club Runs   MTB Name D.O.B. Address Code Tel. e-mail Tick if second claim membership is required Name of first claim club A family rate exists as a concession for families of fully paid up Senior Members and is levied at half the normal rate. This does not apply to those who wish to compete in open races. Please make Cheques / Postal Orders payable to Hull Thursday Road Club. I wish to apply for membership to the Hull Thursday Road Club and agree to abide by the rules and regulations of the club.   Please fill in and print this form off, then sign and date it before sending to the above address. Signature...............................Date..../...../..... *Parental Consent Required For Club Activities: I (name & address)................................................................................................................ Being the Parent/Legal Guardian of ......................................................Hereby agree to his/her taking part in activities of the Hull Thursday Road Club. I am satisfied that my son/daughter is sufficiently responsible and competent to ride in a manner which is safe for him/her self and others. I realise that whilst he/she will be supervised by members of the Hull Thursday Road Club, he/she takes part in activities entirely at their own risk and without liability to the club, its officials or members with respect to injury, loss or damage by him/her however caused. Signature of Parent/Guardian........................................Date..../...../.....