Thank you for your payment please confirm membership details:
Membership Details
Membership *
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Type *
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Primary Member
Membership Number
(Renewals Only)
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Title *
Name *
(forename and surname)
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House Number/Name *
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Street *
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Address 1 *
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Address 2
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County *
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Post Code *
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Telephone *
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Mobile *
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Email Address *
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Date of Birth *
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Gender *
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I am already a member of the following cycling clubs:
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If you are suspended by any cycling club or organisation, please give details:
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Please select your cycling interests from the list below:
(You may select any many as you like)
Please describe your reason(s) for wanting to join Leicester Forest Cycling Club *
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Family Membership Details (if applicable)
Please complete the following personal details for each member if applying for family membership.
Up to one additional adult and unlimited children under 18 years of age may be included.
2nd Adult
Title
Full Name
(forename & surname)
Your answer
Date of Birth
MM
/
DD
/
YYYY
Gender
1st Child
Title
Full Name
(forename & surname)
Your answer
Date of Birth
MM
/
DD
/
YYYY
Gender
2nd Child
Title
Full Name
(forename & surname)
Your answer
Date of Birth
MM
/
DD
/
YYYY
Gender
3rd Child
Title
Full Name
(forename and surname)
Your answer
Date of Birth
MM
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DD
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YYYY
Gender
Payment Method *
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Payment Date *
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