Summit Velo Membership Application

Before filling out and returning this form please go to http://www.summitvelo.org and read our membership and dues policies under the Membership Tab.

 

By submitting this form and your dues payment you are agreeing to all the terms of those policies.

Renewing ________ New ___________

 

Signed ______________________________________________

 

Name___________________________________________

 

Phone __________________________________________

 

Address ________________________________________

 

City         ________________________________________

 

State      _______________________

 

Zip          __________

 

Email ________________________________________

 

Jersey Size ____________________________________

 

Bibs Size ______________________________________

In case of Emergency _____________________________

Phone          _____________________________

 

Please mail this form and the appropriate dues (checks payable to Summit Velo) to:

 

Summit Velo

P. O. Box 64303

Tucson, AZ 85728