Membership Application

Please enter your first and last name.
Please add your preferred phone number.
Please enter an alternate phone number if you care to
Please enter your street address.
Please enter the City you receive postal mail.
Please select the State you receive postal mail.
Please enter your postal Zip code.
Please enter your primary email address
Please enter your Jersey size. You can see a size chart at https://www.pactimo.com/pages/size-chart
Please enter your Jersey size. You can see a size chart at https://www.pactimo.com/pages/size-chart
Please enter the name of someone we can contact in case of an emergency
Please enter the phone number for your emergency contact
Before filling out and returning this form please go to www.summitvelo.org and read our membership and dues policies under the Membership Tab.

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

Summit Velo
P. O. Box 31514
Tucson, AZ 85751