Thames Mountain Bike Club Membership Form

Thames Mountain Bike Club

Membership form
Select your membership type below. The membership period runs from April 1st to March 31st.

Then fill in your details to register as a member of the Thames Mountain Bike Club.

Membership selection *

Adult Membership 1 Adult Membership

$ 25.00 NZD Quantity

Junior Membership 1 Junior 16 years or younger

$ 15.00 NZD Quantity

Family Membership Two adults and unlimited number of children (Must reside at the same address)

$ 50.00 NZD

Enter coupon

Total

$ 0.00 NZD

Full Name *

First Name Last Name
Address: *

Street Address

Street Address Line 2

Town/City

Post Code
Date Of Birth *

Day Month Year
Date
Gender
E-mail *
example@example.com
Mobile Phone Number
Home Phone Number
2nd Family Member - Full Name

First Name Last Name
2nd Family Member - Date Of Birth

Day Month Year
Date
2nd Family Member Gender
2nd Family Member - E-mail
example@example.com
2nd Family Member - Mobile Phone Number
Add a 3rd Family Member

Yes
3rd Family Member - Full Name

First Name Last Name
3rd Family Member - Date Of Birth

Day Month Year
Date
3rd Family Member Gender
3rd Family Member - E-mail
example@example.com
3rd Family Member - Mobile Phone Number
Add a 4th Family Member

Yes
4th Family Member - Full Name

First Name Last Name
4th Family Member - Date Of Birth

Day Month Year
Date
4th Family Member Gender
4th Family Member - E-mail
example@example.com
4th Family Member - Mobile Phone Number
Add a 5th Family Member

Yes
5th Family Member - Full Name

First Name Last Name
5th Family Member - Date Of Birth

Day Month Year
Date
5th Family Member Gender
5th Family Member - E-mail
example@example.com
5th Family Member - Mobile Phone Number
Add a 6th Family Member

Yes
6th Family Member - Full Name

First Name Last Name
6th Family Member - Date Of Birth

Day Month Year
Date
6th Family Member Gender
6th Family Member - E-mail
example@example.com
6th Family Member - Mobile Phone Number
Add any extra notes or comments you'd like to include here :
Club Rules

All members by ticking the "agree to club rules" box below, agree to abide by the club rules. All members agree that in taking part in any events or activities relating or involving Thames Mountain bike club are at their own risk and release, indemnify and hold harmless Thames Mountain Bike Club and its servants and agents from all and any actions of claims made by the member or any other party on or for the members behalf for; but not limited to: any injury, loss damage or death caused to the member or member’s property whether by negligence or any other reason what so ever.

Submission of the membership form does not automatically guarantee acceptance into the Thames Mountain Bike Club. The club reserves the right to deny acceptance to any person they deem unsuitable.
Payment Options:

After submitting this form, an invoice will be emailed to you with payment instructions
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