New-Members Form

Lincoln Wheelers Cycling Club - eMembership Form

Please complete this form if you are a new member - it is important we hold current information to enable us to contact your or your next of kin in an emergency.

Please note; if you are under the age of 16 please join our British Cycling Go-Ride section, see link at the top of the page.

* Indicates required field

Name *

First

Last

Date of Birth *

Address *

Home Phone Number *

Mobile Number *

Email *

Club membership fees are to be paid annually on 1st January and are as follows - tick as appropriate;

First or second claim (Are you a member of another club?) *

First Claim (I want to race for Lincoln Wheelers) Second Claim (I want to race for my other club)

Please choose age category *

16-17 - £5 18 and over - £15 (for 1st & 2nd claims)

Please pay your annual subs by Bank Transfer; the club account is

Lloyds TSB,
Sort Code 30-94-39,
Account number 14888160.

IMPORTANT - Please add your name in the BACs ID field

If you include your e-mail address, you are agreeing for this to be included on the club data base. This is only available to club officers who need to communicate with members. Please note, email is the club’s preferred method of communication with members.

If intending to ride open or club events please give the following information

Next of Kin - Name *

First

Last

Next of Kin - Contact Phone Number *

Please confirm; *

I wish to become a member of Lincoln Wheelers Cycling Club and agree to abide by the rules of the club. I have read and agree to abide by the group riding guidance I acknowledge that I am responsible for obtaining my own third party liability insurance and that I am otherwise not covered when taking part in LWCC events

Name of Parent or Guardian if under the age of 16 *

Any questions or queries, please contact our Membership Secretary, Nicola Casburn

newmembers@lincolnwheelers.co.uk

Submit