SWCC Membership Form
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Photographs of me can be used by the club.
Yes, I'm Happy
No, I'm not happy
Name
*
First
Last
Date of Birth
Email
*
House No/Name, Street
*
Town/Village
*
Post Code
*
Preferred Contact Number
*
Emergency Contatct Number
*
Emergency Contact Name
*
Membership Category
Senior Riders – 1st claim £10:00
Senior Rider (60 & over) – 1st claim £5:00
Family membership – up to 2 adults + all children under 18 in full-time education – 1st claim £20:00
Junior Riders (16-17 years inclusive) – 1st claim £5:00
Juvenile Riders (under 16) – 1st claim £5:00
Social (non-riding) members £5:00
Second claim £10:00
**Please note, Second claim only applies if you are 1st claim to another CTT registered club.**
Payment Method
*
Bank Transfer
Cheque
Cash
Name of first claim club if you are not a Sleaford Wheeler first claim
Medical Information
Please insert any information that you feel the club should be aware of.
I agree to abide by the SWCC Rules, Regulations and Code of Conduct
*
Yes
To review our Rules, Regulations and Code of Conduct visit https://sleafordwheelers.co.uk/TandC2.html
I understand that I participate in club events, whether on or off the public highway, entirely at my own risk, and that no liability whatsoever shall attach to the promoter of the event, any officials or members of the Club for any injury, loss or damage suffered by me, however caused.
*
Yes
Name of Parent/Guardian (for under 18's)
I confirm my consent to the above rider participating in events organised by the Club in accordance with the above rules and regulations.
Submit
