Home
|
Rides
|
Events
|
Contact
Capital City Cyclists Membership Application
*
Means item is required data entry.
*
Application Type:
Select One
New Member
Renewing Member
*
Membership Type:
Select One
Individual
Family
Partner
*
Date Submitted:
*
First Name:
*
Last Name:
Partner F. Name:
Partner L. Name:
Children's Names:
Ages:
0-6
7-12
13+
*
Street:
Apartment:
*
City:
*
State:
*
Zip:
*
Email:
*
Phone:
(xxx-xxx-xxxx)
*
Road Level:
Select One
NA
EZ Under 12
Slow 12-14
Medium 15-18
Fast 19-21
Racer 22+
*
Off-Road Level:
Select One
NA
Beginner
Intermediate
Advanced
Racer
*
Newsletter:
Select One
None
Paper
Electronic
*
Online Club Directory:
Select One
Include with all info
Include with name(s) only
Exclude
Ride Interests: check all that apply
Advocacy
BMX
Commuting
Duathlons
Family Rides
Racing
Recumbents
Tandems
Touring
Triathlons
Club Interests: check all that apply
Ride Leader
Social Planner
Board Member
Century Volunteer
Community Volunteer
Newsletter
Enter below any additional information about your interests for the online membership directory:
I will bicycle with the Capital City Cyclists on organized or scheduled rides entirely at my own risk. I am completely aware of the risks involved. I will not hold Capital City Cyclists or its officers responsible for any accident resulting in injury or death or damage to bicycle or property while on a bicycle ride with the Capital City Cyclists. The Capital City Cyclists requires that helmets be worn on all rides.
Signature __________________________________________________
Please complete, print, sign and return the application with a check for either $15 for an individual membership or $20 for a family membership. Please make the check payable to Capital City Cyclists, and send it to the following address: Capital City Cyclists; P.O. Box 4222; Tallahassee, FL 32315
