Holme Valley Wheelers 2018 Membership Application Form
To become a member of Holme Valley Wheelers for 2018, please complete this form and click 'Submit'.

Please then send the appropriate membership fee, to club treasurer (details below):

Mrs Jacqueline Haigh
75 Hall Ing Lane
Honley
Holmfirth
West Yorkshire.
HD9 6QW

Tel:- 01484 665 682


Cheques should be made payable to “Holme Valley Wheelers”

The membership rates for 2018 are:

All Senior members (full,second claim and social) £10.00
All Junior members (full,second claim and social) £5.00
(Junior membership applies to persons under 18 years of age)

If you joined after 30th September 2017, your membership will continue to the end of 2018, without any further payment. You will need to confirm that the information that you provided has not changed, provide updated information where appropriate and in all cases advise on the 3rd party liability insurance cover, for cycling as required below.

Members who do not renew their membership by the date of the 2018 AGM (6th February 2018), will be deemed to have left the club.

If you have any queries regarding completing this form please contact Jacqueline Haigh 01484 665 682.

Email address *
Personal Details
Surname *
Your answer
First Name(s) *
Your answer
Date of Birth *
dd/mm/yy
Your answer
Gender *
Address *
Your answer
Telephone Home
Your answer
Telephone Mobile
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Email Address
Your answer
School Attended (18 and under only)
Your answer
3rd Party Liability Insurance *
The club's constitution requires that all riding members must have 3rd party liability insurance, issued by one of the 3 organisations listed below. It will be necessary to confirm insurance details, before accepting renewal of membership. The treasurer will not bank cash or cheques until we have all of the information needed. Non riding social members do not need to have 3rd party liability insurance. Please select your insurance provider from the list below:
What membership type are you applying for? *
My BC / Cycling UK (formerly CTC) / TE membership number is:
Your answer
My BC / Cycling UK (formerly CTC) / TE membership expiry date is:
dd/mm/yy
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Next of Kin Details (in case of emergency)
Name *
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Address *
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Telephone *
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Please use the box below for any comments you would like to make about the club.
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Declaration
The club store personal data for membership purposes and conducting club business. By submitting this form, I consent to the club holding my data.
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