Cycling Geelong Membership Application Form

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Prospective new members please fill out this form. Details will be sent to you, via email, of how to pay your membership subscription.

Cycling Geelong Members at a recent Barwon River ride

First Name *

Family Name *

Address (Street number and name) *

Town *

Postcode *

Contact details

Please supply at least one phone number

Mobile Phone number

Home Phone number

Email Address

Membership Category *

Individual ($50)

Concession ($35)

Family (up to two adults and any children under 18 living at the same address) ($70)

Cycling Geelong Purpose and Objectives *

I support the purposes and objectives of Cycling Geelong (See Cycling Geelong website)

Cycling Geelong Rules *

I agree to comply with the Cycling Geelong Inc. Rules. (Based on the Clubs and Associations Model Rules)

Photography

Photographs are taken on rides and club events for the Cycling Geelong website and Facebook page etc.
If you do not wish to have your photograph taken for club use, please ensure that you tell any photographer this, and make sure you are not in group photographs.

I agree to be photographed at Cycling Geelong events. (Tick if you agree)

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