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 ____________________________________ ( M / F)

Bibs Size ______________________________________ ( M / F )

In case of Emergency _____________________________

Phone          _____________________________

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

Summit Velo

P. O. Box 31514

Tucson, AZ 85751