FOLKS ON SPOKES - MEMBERSHIP APPLICATION
P.O. BOX 763 MATTESON, IL 60443
I, for myself and for any minor on whose behalf I sign this membership application, agree that: (1) bicycling is a potentially hazardous activity and that accidents can occur from negligence or carelessness; (2) ride leaders and maps are provided for my convenience only and not to guarantee a safe route or trip; (3) I voluntarily participate in club events and assume all risks associated with participation therein, including but not limited to; injury, falls, contact with other participants, weather, traffic and road conditions; all such risks being known and appreciated by me. I also agree to wear a helmet that meets Consumer Product Safety Commission (CPSC), ASTM, or Snell standards on all rides. Please Print
Names(s)_____________________________________Age:____________________________
_____________________________________________Age:____________________________
Address:______________________________________________________________________
City:_________________________________________State:__________________________
Zip:__________________________________________Phone:__________________________
E-mail:_______________________________________________________________________
Do you want your email address published in the club roster? Yes____ No____
Signature:_____________________________________Date:___________________________
Please indicate: New Membership ________ Renewal Membership ________
Additional family member(s):
Signature of parent or guardian if under 18
Name:________________________________________Age:____________________________ Signature:_____________________________________Date:___________________________
Name:________________________________________Age:____________________________ Signature:_____________________________________Date:___________________________
Name:________________________________________Age:____________________________ Signature:_____________________________________Date:___________________________
ANNUAL DUES:
Single $20.00 Family $30.00
All Memberships Expire Dec. 31
Total enclosed:___________________________________________Date:_________________