Dame Cycling - Membership


Before joining, make sure you review the Benefits.

Joining Form


Membership Type *
Jersey Details
Only complete when you select the £65.00 membership
Size
Colour
Personal Details
Name *
Name
Address *
Address
Please provide your full address
Preferred Contact Number
Preferred Contact Number
Medical Declaration
Have you (or the person you are signing for) ever suffered a serious injury or discomfort whilst riding? *
Your Riding Details
What is your discipline?
Rider Level *
Emergency Contact Details
Contact Name
Contact Name
Contact Address
Contact Address
Contact Number
Contact Number
How To Pay
You can transfer the funds directly into our back account. Please use your SURNAME followed by MEMBERSHIP as reference
lloyds - dame cycling
Sort Code: 30-13-35
Account Number: 66168760
Disclaimer
I understand that the information I have given will be held in accordance with the Data Protection Act 1998. I acknowledge that RIDING IS A RISK SPORT AND HOLDS POTENTIAL DANGER, Dame Cycling is not responsible for anything that happens to you while you are riding your bike with us. We love you very much and of course will look after you, we can only advise but ultimately it is down to you what you do and what you don’t.
Please type your full name in capital letters