Newport Phoenix Cycling Club

Phoenix Flyers Youth Cycling Team

Sponsored by: Gwent Cycles

Membership Application Form2017

Name: …………….………….………..…………………………………..……… Date of birth: ……..………..……….…………………

Address: ……………………..…………………………...……………………………………………………………………………………...

……………………………………………………………….…………………………………………………………………………………….

Post code: ……………………...………….Home Tel: …………………………Mobile: ………………………………..…………..

E-mail address (very important) …………………..…………………………… Emergency Contact Tel: ……………..…………

Allergies (if any): ………………..…………….……………………………………………

I am particularly interested in (please tick all appropriate):-Road Racing  Mountain Biking / DH

Time Trials  Track Racing  Other  (please specify)………………………………………………………….

Club membership fees for 2017Tick box

Senior(over 18)£30.00

Junior (16 to 18)£15.00

Juvenile(under 16)£10.00

Full family membership£50.00 Complete separate forms for all members

(2 Adults and 2 Children under 16)

Second claim member£10.00 (First claim club: …………………….……..)

Membership will run until the end of February 2018 with new Membership from then on commencing 1 March.

Please read the following important notes: -

Newport Phoenix Cycling Club STRONGLY recommends the following: -

  1. All members should be covered by insurance equivalent to that provided by the British Cycling Federation. It is your responsibility to ensure that you are adequately covered. Contact your club Secretary for details.
  2. All members should wear appropriate approved safety crash helmets AT ALL TIMES(compulsory for under 18’s).
  3. Second claim payment is discretionary and the committee will have the final decision.

Conditions of membership: -

1.I agree to abide by the rules of The Newport Phoenix Cycling Club.

  1. All members under the age of 18 years must have a parental consent form signed by their parent or guardian.
  2. All members intending to enter BC road races, track, mountain bike and Cyclo-cross events require ‘British Cycling’ membership and a BC racing licence. BC membership is available through your club Secretary.
  3. Club membership runs from 1stMarch each year. New members joining after 30thAugustwill pay half the above membership fees.
  4. Members joining within 3 months of the start year date will pay full fees and be members for the forthcoming year.
  5. All members, including Life Members, must return a completed and signed membership form when requested.

Signed (member’s signature): ………………………..………..………..……Date: ………………………

Completed membership application forms and the correct fee should be sent to:-
Mrs J Davies - Membership Officer
Newport Phoenix Cycling Club
68 Clevedon Road
Newport
NP19 8ND Tel: (01633) 664256

(Cheques payable to ‘Newport Phoenix Cycling Club’)

Official use only: Membership form submitted (date):……………..….……… Fee paid £ ………………..

Signature of club official:…………………………