Leigh Premier Road Club

Founded 1964

 
Membership Application Form 200….

 

 

 

Full Name    …………………………………………………………………

 

Address       ………………………………………………………………...

 

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Post Code   ………………….      Phone No  …………………………..

 

Email   ……………………………………………………………………….

 

Category                                       Annual Subs          Tick appropriate box

 

Senior

£10

 

Junior

£10

 

Juvenile

£5

 

Social

£5

 

2nd Claim

£5

 

 

Previous Club (if any) or 1st Claim club ………………………………………….

 

Interests and memberships

 

Please list any other club memberships (ie BCF  CTC etc) and what you cycling interests are

(ie road race, time trial, cyclo-cross, MTB, touring,coaching etc)

 

 

 

 

 

 

I wish to apply for membership of Leigh Premier Road Club and agree to abide by its rules, regulations and by-laws.

 

 

Signed ……………………………………     Date …………………….

 

Parental signature if under 18  …………………………….

 

Membership application is subject to the approval of the committee.