Bristol South Cycling Club

Affiliated to BCF, RTTC & WTTA

Application for Membership
Complete this form and post to the club secretary.

 
Surname 
Other Names 
Date of Birth 
Postal Address (incl Post Code)


 
Phone Numbers (home, work, mobile) 
E-mail Address 
Are you (or have you been) a member of any other cycling organisation? If yes, name the organisation and give reasons for wanting to join Bristol South CC  
Existing member who sponsors the application 
In case of Emergency:
Contact Name
Phone No
Blood Group
 
Which aspects of cycling are of particular interest to you?
Audax Cyclo-cross Road racing
Time trials Track racing Social club rides

If my application is approved by the club committee, I will:

- abide by the club rules and respect the authority of the club officers.

- arrange 3rd party insurance by joining a recognised cycling organisation (e.g. BC, CTC)

- agree to my membership details being stored electronically

Signature of Applicant:
Date:

Membership approved / not approved at the club committee meeting held on :

Signed
(chairman of the meeting)


Club Secretary: Geoff Partridge, 52 Montrose Park, Brislington, Bristol BS4 4JF