Membership Registration Form

Note: If paying via Ath Movil fill application form first, scan qr code below to sumbit payment then finalize application by selecting submit registration. Please include the applicant's name and the relevant membership type in the Ath Movil description box. (Example: Junior Membership fees for John Doe). For cash and check payments, registration will be on file and completed when payment is made.

Full Name

Date of Birth

Date

Address

Contact Number

Please enter a valid phone number.Format: (000) 000-0000.

E-Mail

example@example.com

Emergency Contact Name

Emergency Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Relation to Member

Payment Method

Other

T Shirt Size

My Products

Junior Membership

Free access to:

BVI Riderz Social Group Rides

Development Training

BVI Riderz Workshops

Community hours for school.

Discounted Race entry fees

10% off BVI Riderz Merchandise

$30 Annual Fee

$30.00 Quantity

Supporter Membership

Free access to:

BVI Riderz Social Group Rides

Development Training

Access to BVI RIderz Workshops

Discounted Race entry fees (Non Competitive Class)

10% off BVI Riderz Merchandise

$40 Annual Fee

$40.00 Quantity
Item subtotal:

Vendor Membership

For mechanics, suppliers and vendors to our cycling community. You will be given access to provide support, advertise and sell products at our events.

$50.00 Quantity

Race Membership

For the race warriors who live for speed and adrenaline boost races.

Free access to :

Social group rides

BVI Riderz Workshops

All BVI Riderz events

Includes UCI racing license

Free Race Entry

15% off BVI Riders Merch

$95/yr.

$95.00 Quantity

BVI Riderz T-shirt

100% polyester Branded dry fit t-shirt, perfect for athletic use or casual wear.

$25.00 Quantity

ATH Movil Payment Link

Free Quantity

Total

Membership Registration Form

Member Information

Emergency Contact Information

Waiver and Consent

My Products