Join Rocko 2023

Rockingham Forest Wheelers Membership Form

Applicant's Personal Details

* Indicates required field

Title *

Name *

First

Last

Gender *

Date of Birth *

Main Email *

Alternative (Work?) Email *

Preferred Phone *

Mobile Home Work

Mobile *

Home *

Work *

Address line 1 *

Address line 2 *

Town/City *

County *

Postcode *

Country (if not UK) *

Emergency Contact

We need to have a contact point to inform in the case of an emergency.

Emergency Contact Name *

Relationship to Person Applying for Membership *

Emergency Mobile No *

Emergency Alternative Phone No *

Contact Address Line 1 *

Contact Address Line 2 *

Contact Address Postcode *

Club Membership

Membership Type and Fees

Other Club - Please give details of all cycling clubs/teams you have been a member of in the last 12 months (or 'None'). *

Member Claim Type *

RFW as First Claim (your main club/team) RFW as Second Claim (a secondary club for you)

If you belonged to a British Cycling affiliated club before, and now want to join RFW as a First Claim, you MUST have formally resigned from your previous club. By submitting this form you are confirming this.

This Application is for me as... *

... an Individual Adult ... part of a Couple/Family ... an Individual Juvenile or Junior

If joining as a couple, both partners must separately complete one of these forms, and name the other partner below. *

Prices are

£15 for Adult - First Claim
£7.50 for Adult - Second claim (if already member of another British Cycling club, which you must name in the box above left)
£25 for a Couple/Family
£5 for Juniors (under 18)
Juveniles (under 16) are free

Please pay by sending the correct amount to our bank account, describing the transaction using 'NEW yourname'.
Our account details are

Sort Code = 40-26-07
Account No = 61871005

Press to Join the Rocko