E-mail Address:

First name

Family name

Address

Post Code

Home Telephone

Mobile Telephone

Emergency Contact Name
To be contacted in the event of an emergency

Emergency Contact Numbers (Home & Mobile)
Telephone numbers to be used in the event of an emergency

Additional information for ride leaders
Include details of medication or medical issues of relevance

I have read and agree to the conditions of membership as detailed on the Club Conditions page and agree to pay the annual membership fee.

I accept the groups Data Protection Policy.