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 Adult Membership Only available to people aged 18 or over.	£30.00
	2nd Claim Adult Available for members of a different club. This offers restricted access to some VCL events. Can join club ride, VCL chaingang and discount to Saturday session. Excludes bike hook. Only available to people aged 18 or over.	£30.00
	Youth/Junior Youth/Junior Membership (under 18 – must be paid by an over 21, who in doing so is allowing continuing consent) Only available to people up to the age of 17.	£15.00
	2nd Claim Junior For 1st claim members who have been within the club for more than 2 years and are moving to a team Only available to people between the ages of 16 and 17 inclusive.	£15.00
	Social Social Membership Only available to people aged 18 or over.	£5.00
	Family Membership Family Membership (up to two adults, and four children) Only available to people aged 18 or over.	£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 certain club administrators 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

Title

Description

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