Membership Application Please enable JavaScript in your browser to complete this form.Are you a:Renewing MemberNew MemberName *Please enter your first and last name.Preferred Phone Number *Please add your preferred phone number.Alternate Phone NumberPlease enter an alternate phone number if you care to Street Address *Please enter your street address.City *Please enter the City you receive postal mail.State *ArizonaCaliforniaColoradoNew MexicoPlease select the State you receive postal mail.Zip *Please enter your postal Zip code.Email *EmailConfirm EmailPlease enter your primary email addressJersey SizeSmallMediumLargeExtra LargePlease enter your Jersey size. You can see a size chart at https://www.pactimo.com/pages/size-chartMens or WomensMensWomensBibs SizeSmallMediumLargeExtra LargePlease enter your Jersey size. You can see a size chart at https://www.pactimo.com/pages/size-chartMens or WomensMensWomensEmergency Contact Name *Please enter the name of someone we can contact in case of an emergency Emergency Contact Phone Number *Please enter the phone number for your emergency contactAnything you want to tell us?Before filling out and returning this form please go to www.summitvelo.org and read our membership and dues policies under the Membership Tab. By submitting this form and my dues payment, I agree to all the terms of the team policies.MessageSubmit Please mail the appropriate dues (checks payable to Summit Velo) to: Summit Velo P. O. Box 31514 Tucson, AZ 85751