Decatur Bicycle Club, Inc. of Decatur, Illinois
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Please print form, fill out and mail

Decatur Bicycle Club Membership Application Form

Check one

_____New Membership

_____Renewing

Make check payable to:

DECATUR BICYCLE CLUB
PO BOX 3353
DECATUR IL 62524-3353


Membership Application

_____ Individual $10.00

_____ Family     $15.00

Signatures of All Applicants Involved

Name Date

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Name__________________________________

Address _______________________________

City___________________________________

State & Zip_____________________________

Phone(__________)______________________

Email Address___________________________


Disclaimer: In signing this form, I understand and agree to absolve the Decatur Bicycle Club, Inc., it's members, and it's officers of all blame for any injury, misadventure, harm, loss, or inconvenience suffered as a result of taking part in any activity sponsored or advertised by said organization.

If other members in the household would like to receive the Club Newsletter or other
mailings, please list the e-mail addresses below

 

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Copyright 2001 Decatur Bicycle Club, Inc.