Elko Velo Membership Application

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Primary Phone Number

Format: (000) 000-0000.

Mobile Phone Number

Format: (000) 000-0000.

Email Address

example@example.com

May we share your email address / phone number with other club members?

Additional Family Members

Rows	Name	Email
Family
Family
Family
Family

What time of bike(s) do you ride:

Rows	Novice	Intermediate	Advanced	Other
Road
Mountain
Comfort
Other

Volunteer Opportunities

I, the undersigned, understand that ELKO VELO is a non-profit, recreational cycling club for the express purpose of promoting the sport of bicycling, bike safety, and providing camaraderie and fellowship amongst its members. Membership in Elko Velo in no way implies liability on the part of the club. I understand execution of a Release Agreement for Elko Velo events is a requirement for my participation in club events. I also understand that Elko Velo has a mandatory helmet rule. As a member of Elko Velo, I will wear my helmet on all Elko Velo club rides. If I forget my helmet for an event, I recognize that I will not be able to ride with the club at that event.

Signature

Date

Please make checks payable to and send to: Elko Velo Cycling Club PO Box 1364

Membership Application

APPLICANT INFORMATION

ANNUAL MEMBERSHIP

RIDER INFORMATION

VOLUNTEER OPPORTUNITIES