[go: up one dir, main page]
Scribd
Upload
95 views1 page

California Bicycle Racing Membership Form

This document is an annual membership application for California Bicycle Racing for the year 2006. It requests contact information, racing experience level, and emergency contact. Members agree to assume all risks and liability and release the organization from any accidents or injuries. Fees are listed for adult, junior and package memberships including apparel.

Uploaded by

lp456
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
95 views1 page

California Bicycle Racing Membership Form

This document is an annual membership application for California Bicycle Racing for the year 2006. It requests contact information, racing experience level, and emergency contact. Members agree to assume all risks and liability and release the organization from any accidents or injuries. Fees are listed for adult, junior and package memberships including apparel.

Uploaded by

lp456
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

714/356-1214 VNCRacing@[Link] P. O.

Box 114; Sunset Beach, CA 90742-0114

California Bicycle Racing 2006 Annual Membership Application

EMAIL will be our primary communication for changes, notices, etc.


Please print clearly and use each box for letter/number/symbol, e.g.

F R E D @ R A C E R .

C O M

Email Name Street


City, St. Zip

, CA
Birthdate Contact Name Home ( ) Category Work ( ) Contact Phone ( ) )

Racing Club Emergency Telephone

/
-

/
-

Mobile ( (W) Phone IV (Apprentice) III (Intermediate)

Best contact? Email CBR Road Racer Membership Renewal New

(H) Phone

(M) Phone V (Novice) V (Experienced)

Snail Mail II (Advanced) I (Elite)

New members: please send in documentation to substantiate the above category if you have prior experience. Racers new to bicycle racing will be given a Road Category V (Novice).

ADMISSION OF RISK AND LIABILITY RELEASE I am applying for racing membership in California Bicycle Racing. I understand and accept the fact that racing a bicycle can be dangerous & fatal, and I fully accept the risk that may be involved. I wish to forever release California Bicycle Racing, its clubs, employees, members, promoters, officials, volunteers, participants and sponsors from any liability due to any accidents in bicycle races involving California Bicycle Racing. I presently do not know of any mental or physical condition that would affect my ability to participate in bicycle races except for
Signature of Applicant (Must be signed in ink.) Dated

PARENT OR GUARDIAN MUST COMPLETE THIS FORM FOR MINORS


I am the parent or guardian of the above listed Applicant, and assure California Bicycle Racing that the facts listed above concerning my child or ward are true. By signing this form I am giving my permission for my child or ward to enter any bicycle race or event sanctioned by California Bicycle Racing during the period of the membership applied for and also agree to the terms of the above listed ADMISSION OF RISK AND LIABILITY RELEASE.
Signature of Applicant (Must be signed in ink.) Dated

Racing age is whatever age you are on December 31, 2006. Juniors are racing ages 17 years & below

CBR Road Racer Membership Fees (check 1 box only)

Adult-$25 (until 1/31/06) Adult $30 (after 2/01/06)

Adult + CBR jersey-$60 Adult + CBR jersey & bib shorts-$95

Insiders Club-$500 Junior-$10

Website: [Link]

Please make your check payable to and mail it, along with this form to California Bicycle Racing, Post Office Box 114; Sunset Beach, CA 90742-0114
Membership term is January 1 through December 31

You might also like