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VeloElite RC Application & Renewal Membership Form 2018

VeloElite Cycling Club Membership, is now open. Please either complete the electronic form below, or if you prefer you can download a PDF version here.

The club year runs from 1st January – 31st December. Any member not renewing by 31st March will be deemed to have left the club

Annual Membership:
Over 18 – £20
Under 18 – £5

Please make payment by BACs to:
Name: VELO ELITE RC
Sort Code: 30-98-97
Account Number:5735 0768
Please put your name as Reference

Please complete the form accurately and ensure all required fields are correctly completed. We will match your membership application to you BACs payment and confirm your membership as quickly as possible.

Rider Name (Required)

Date of Birth (Required)

Full Postal address including postcode (Required)

Mobile Phone number (Required)

Home Phone number

Email address (Required)

Disciplines you would like to take part in: (please tick selection)
Road/Track RacingMountain bike RacingCyclocross RacingCompetitive TimetrailsSportivesRecreational RidesCharity RidesClub training ridesCoached sessionWomen Only rides/sessions

If you Compete within a chosen discipline please list your details below
Discipline
Age Group
Category/Level

Membership type:
1st Claim2nd Claim

If you are a member of another club list here (if applicable):

Members who belong exclusively to VéloElite RC are deemed first claim members. Members who belong to another club as first claim members may still join and take advantage of club incentives and continue to be insured for any club events*

Medical Information -
Please detail below any important medical information that our Club representatives should be aware of (e.g. epilepsy, asthma, diabetes, a recent injury or disabilities). Please note any recommended treatment or action if symptoms appear

Emergency Contact Details (for use if an accident was to occur)
Contact name:
Contact number:
Contact relationship:

Data Protection:
The information you supply will be held by the club in digital format. This information will only be used for club business. It will not be shared with any other organization.