ASHFORD WHEELERS CYCLING CLUB
APPLICATION FOR MEMBERSHIP
SURNAME:   DATE OF BIRTH:
CHRISTIAN NAME(S):
ADDRESS:
 
  Tel No:
 
Tick your category choice   OFFICE USE ONLY
MEMBERSHIP CATEGORY     Fee  
 
Senior     £22.00  
Junior (16-18 years)     £11.00  
Juvenile (Under 16 years)     £7.50  
Associate Member     £6.00  
Second Claim Member     £14.00  
 
I wish to apply for Membership of the Ashford Wheelers Cycling Club and agree to abide by the Rules of the Club and pay appropriate Membership Fee according to my choice of category.
I also agree and understand that the Ashford Wheelers Cycling Club does not accept liability for any claim whatsoever arising from personal injury, injury to others, loss or damage to any property caused by or involving any Member of the club.
 
 
Signed:..........................................................    Date:..........................................
 
When you are ready please complete this membership  
form and return it to:
David Roe (Club Secretary)
Owls Nest Cottage, Kingsnoad Farm, Pye Corner,
Ulcombe, Kent, ME17 1EG