Cannonballs Cycling Team New Membership Application

 

Name: ____________________________________________________________

 

Address: __________________________________________________________

 

City, State, Zip _____________________________________________________

 

Home phone _________________ Work phone _________________ Mobile phone _________________

 

Birthday ____/_____/___ E-mail ______________________________________

 

 

New Membership Due:  $75

 

Waiver

I understand that participation in Cannonballs Cycling Team activities is at my own risk and that Team policy requires that I obey all traffic laws and wear an approved safety helmet. My participation in Team activities constitutes my representation that I am able to operate my bicycle properly and that my bicycle is in good mechanical condition, and my acknowledgement that the officers and ride leaders of the Team cannot assume any liability for personal injury or property loss sustained during Team activities. By my signature below, I fully release the Team and those individuals from any liability, specifically including but not limited to liability for their negligent acts, stemming from or relating to past or future Team activities or events.

 

I HAVE READ AND UNDERSTOOD THIS NOTICE AND RELEASE, AND INTEND TO BE LEGALLY BOUND BY IT.

 

Signature: ______________________________ Date:_________

Must be SIGNED by Parent or Guardian if APPLICANT is under 18.

 

 

Please identify your interest of team activities  (please select two):

ٱ "Ride For Pride" Event Planning

ٱ "Trips For Kids" Volunteer

ٱ Bicycle Advocacy

ٱ Committee (Apparel, Newsletter, Safety, Social)

ٱ Other _____________________________________

 

 

Send application and payment to:

Cannonballs Cycling Team

P.O. PO Box 481442

Charlotte, NC 28269

www.cannonballs-cycling.org

 

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