Comeragh Cycling Club Waterford Membership Form

Name **

First NameSurname

Address **

Street Address

Street Address Line 2

CityCounty

EircodeCountry

Date of birth **

DayMonthYear

Phone Number**

Email **

Confirmation Email

Next of Kin*

Relationship to applicant.*

Spouse, Parent, Sibling etc.

Next of Kin Phone Number*

Next of Kin Email

example@example.com

RELEVANT MEDICAL CONDITIONS, if any (Asthma, allergies etc.)

Type Of Licence*

For Racing Licence Please Select*

For Underage Licence Please Select*

Where the applicant in under the age of 18 at the time of application please have a parent/guardian fill out the Parental Consent and Release Form here;

Parental Consent and Release Form.

Parental Consent & Release From Complete.*

For Students Please Upload Photo of Student ID Card

Choose Photo

Applicant is:

Existing MemberReturning/Previous memberTransferring From Other CI ClubNew Member

By submitting this form you agree to the following;
To abide to the clubs code of conduct.
For Senior riders - As part of my club membership I agree to make myself available for our Annual Summer League which all members are required to do 2 nights of marshalling and the Comeragh Youth Academy League & training spins (Approx 4 times over an 8 month period). I also agree to help out if required with other events like “The Copper Coast Sportive” etc.

A minimum of a Cycling Ireland Leisure Licence is required to partake in our club spins. Click here to take out new or renew existing Cycling Ireland Licence/Membership

Please verify that you are human*

Comeragh Cycling Club Waterford Membership Application Form 2023