
Address:
Postcode:
Tel:
E-mail:
Age(if under 18):
Date of Birth (if under 18):
N.B. The following MUST be completed where the applicant is under the age of 18.
I agree that my son/daughter/ward (cross out none applicable) may join St Helens Cycling Racing Club.
I accept that it is a club run by honorary officials on a voluntary basis for the betterment of cycling
and the benefit of the community. In case of any accident that St Helens Cycling Racing Club
or any club official or member of the club cannot be held responible.
Signed(Parent/Guardian):Date: