Renew Rocko 2024

Rockingham Forest Wheelers Membership Renewal Form

Applicant's Personal Details

Have your details changed...?

Select one of ... *

My Personal Details have not changed since last year. The details completed below have changed

Title *

Name *

First

Last

Gender *

Date of Birth *

Main Email *

Alternative (Work?) Email *

Preferred Phone *

Mobile Home Work

Mobile *

Home *

Work *

Emergency Contact

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

Select one of ... *

My Emergency Contact is the same as it was last year Note NEW Emergency Contact details as completed below

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

* Indicates required field

Member Claim Type *

RFW as First Claim (your main club) 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.

If you are joining as a Second Claim, you must tell us who your first claim club is below, and they must be affiliated to British Cycling.

First Claim Club (must be BC affiliated) *

Prices are

£15 for adult, first claim
£7.50 for adult, second claim
£25 for a couple or family (DOES YOUR PARTNER RIDE?)
£5 for Juniors (under 18)
Juveniles (under 16) are FREE

This Application is for me as... *

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

If joining as a couple/family, both adultsmust separately complete one of these forms, and name the other family members below. *

Donation

I would like to help the club by voluntarily donating an additional £10 to help with cycling development. *

Yes, I will add £10 to my membership fee No thanks

Payment

Please pay by sending the correct amount to our bank account, describing the transaction using 'Sub24 yourname'.

Our account details are

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

Press to Renew Rocko Membership