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Tel/Fax: 011 314 4628 P O Box 7337, Halfway House 1685 www.mccycle.co.za • email: firstname.lastname@example.org MEMBERSHIP APPLICATION Membership type Principal Family Junior (min 12 yrs) Honorary Life Please complete in block letters Chip Nos ship type Member- Surname First Name ID No Winning Champion Time Chip Postal address: Postal code: Physical address: Postal code: Tel No – Home: Tel No – Work: Cellular No: Email address: Fax No: Medical Aid: Medical Aid No: Emergency Contact Tel Emergency Contact Person: No: INDEMNITY Membership of MCC is granted on the distinct condition that neither MCC, nor any office bearers of the Club, accepts responsibility for any injury or illness sustained or suffered by any person or for any theft or loss or damage to any property occurring during Club outings or activities, however caused, and whether due to the negligence of the Club or any of its office bearers or arising in any other manner or from any other cause whatsoever. The applicant undertakes to acquaint him/herself full with the Club’s Constitution. Signature: ______________________________________________________ Date: ______________________ Parent/Guardian (if under 18) ______________________________________________ Date: ______________________ Receipt to be returned to new member _____________________________________________________- has been granted membership of MCC. ___________________________________ (Committee Member’s signature) PAID: R__________________________ Sunday Road rides: from the Club, Plot 210, 35 Austin Road, Glen Austin, Midrand Times: 1 September to 31 April (summer) 07h00 1 May to 31 August (winter) 07h30 Saturday MTB rides: from Mugg & Bean, Carlswald Lifestyle Centre Times: 1 September to 31 April (summer) 06h00 1 May to 31 August (winter) 06h30 (Please turn over) MEMBERSHIP FEES Admin Fee R Paid R Annual subscription R Per full member Paid R Annual subscription R Per active family member Annual subscription R Per in-active family member Paid R Annual subscription R Per junior member (12-18) Paid R TOTAL PAID R BASIC RULES: All applicants must be able to ride a bicycle with total confidence and must be able to cover a distance of 30kms with ease. Bicycles must be in good condition with emphasis on brakes, tyres, deraileurs and jockey. A puncture repair kit or spare tube, a good pump and plastic water bottle to be carried on each ride. Head protection in the form of a hard helmet is required. No Helmet, No Ride. Advice on care and condition of bicycle will be given on request. Efforts will be made to ensure no rider gets abandoned on a ride due to tyre failure, a fall or an accident. Minimum age for a Junior member is 12 years.
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