MANX VIKING WHEELERS CYCLING CLUB

(A company limited by guarantee)

Affiliated to British Cycling, The League International,

Cycling Time Trials & the Isle of Man Cycling Association

2015 Membership Application/Renewal Form

Name
Address / ______
______
______Postcode ______
Telephone number / Home: / Work/Mob:
Email address
Date of birth

All members may be asked to marshal (or provide a suitable marshal) for one of the clubs events.

Please tick the box of which event you would be willing to help marshal

MVW Handicap Road Race (Sunday 5th April 2015)

MVW Penrice 25m TT (Sunday 10th May 2015)

MVW Tour of the Middle Road Race (Sunday 14th June 2015)

MVW Tour of the West Road Race (Sunday 2rd August 2015)

MVW Geoff Quine Memorial Hamper Race (Sunday 27th December 2015)

I wish to apply for/renew my membership of the Manx Viking Wheelers Cycling Club for the year ending 31 December 2015 and I agree that if my application is approved, I shall abide by its Memorandum and Articles of Association and other rules and conditions (if any) for the time being in force.
Signature______Date of application ______
A cheque in the sum of £20.00 (Seniors), £15.00 (Social) and £10.00 (Juniors) for my 2014 subscription is attached.

Please make your remittance payable to: MANX VIKING WHEELERS CYCLING CLUB

Please return this form together with your remittance (if applicable) to:

Mrs Jayne Black

Secretary, Manx Viking Wheelers

21 Marathon Avenue, Douglas, IM2 4JB

Amount Rec / £ / Date / Completed