Registration Form

Personal Details = required

Full Name

Home Address

Home Phone

Work/Other Phone

Mobile Phone

Email Address

Alternate Email

Date of Birth

Gender

Male Female

Occupation

(Please indicate if you would be willing to help the club should it need your expertise.)

Membership Start

When would you like your membership to start?

As Soon As Possible Specific Date

Preferred Start Date
(if applicable)

Membership Category

Please select your preferred membership category

	Category	Cost
	Adult Coach VCL qualified coaches free for on year at a time	£0.00
	Adult Commissaire VCL qualified Commissairess free for one year at a time	£0.00
	Elite Senior members with Elite license	£0.00
	Youth Coach VCL qualified coaches free for on year at a time	£0.00
	Adult Adult Membership Only available to people aged 18 or over.	£30.00
	Youth/Junior Youth/Junior Membership (under 21 – must be paid by an over 21, who in doing so is allowing continuing consent) Only available to people up to the age of 21.	£15.00
	2nd Claim Adult Available for members of a different club. This offers restricted access to some VCL events	£30.00
	Social Social Membership	£5.00
	Social - Volunteer Family member who volunteers for the club	£0.00
	Family Membership Family Membership (up to two adults, and four children)	£40.00

Data Protection

I understand that any personal data I provide on this site will be processed in accordance with the Terms & Conditions and Privacy Policy. I have read and agree to the Terms & Conditions (https://vcl.myclubhouse.co.uk/Home/TermsAndConditions) and the Privacy Policy (https://vcl.myclubhouse.co.uk/PrivacyPolicy;).

Signature

Date

Please return completed forms to: Velo Club Londres, Herne Hill Velodrome 104 Burbage Road Herne Hill London UK SE24 9HE

Use this form to send an email to another member. You may only send to one member at a time. Your registered email address will be passed on to this member but you may also include alternative contact details.

Note: Emails sent via the website are not entirely private. A copy of every email is held on the database and this can be accessed by the club officers using the Sent Emails page.

From

Alternative contact email

Another email address which the recipient can use to contact you.

Alternative contact details

Other contact details which the recipient can use to contact you e.g. phone number.

Subject

Message

Copy this message to my email address

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Regular

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Title

Description

Requested Membership Subscriptions

One or more of the requested Membership applications require approval. You will be emailed if your request has been approved and, at that point, you will be able to view and accept or reject the membership offer and proceed with payment. will be emailed once the request has been approved and, at that point, they will be able to view and accept or reject the membership offer and proceed with payment.

Subscriptions have been automatically approved and have been added to your basket. Please now proceed there to make payment.

Pay for Subscriptions

Reference	Name	Category	Costs
			Joining Fee Cost /	View Manage

Group Subscriptions

- :

You have requested one or more group membership subscriptions. You should now use the register buttons below to add additional members into the available slots.

No.	Membership
	One of:

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