Polk Pedalers Bike Club Membership Form
If you have any difficulty with this form, please email treasurer@polkpedalers.com

Thank you for becoming a member of Polk Pedalers cycling club. There's just two steps to complete:
1) Fill out this membership form
2) Pay your dues

Dues can be paid online via debit card at this link: https://cash.me/$MarshallG
Note: Please include your name and "PP Dues" in the note section, for example "Marshall Guthrie - PP Dues"

Dues can be paid by mailing a check to:
Marshall Guthrie
1631 Teton Dr E
Monmouth, OR 97361

For information on other forms of payment, or if you have any questions, please contact the club treasurer at treasurer@polkpedalers.com

Membership runs January 1-December 31. Dues are as follows (2017):
$30 - Couples
$20 - Individuals
$5 - Under 12 years old (on date of payment)

Email address
First Name
Your answer
Last Name
Your answer
Membership Type
Please select all that apply. You will be contacted after payment to provide additional names for couples and youth memberships.
Phone Contact
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A copy of your responses will be emailed to the address you provided.
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