Name:________________________________________________________
(List all members included in your membership)
Address:_____________________________________________________
(include City, State, Zip, Apt.)
Home Telephone: (_____)_____________________
Work Telephone: (_____)_____________________
E-Mail:______________________________________________________
(optional)
Read and Sign the Following Release of Liability Agreement
blah, blah, blah
(not valid until we get the legal text here)
_____________________________________________________________
Signature and Date
_____________________________________________________________
Co-applicant Signature and Date
| Single | $14.00 |
| Couple | $20.00 |
| Full-time College Student | $8.00 |
Enclosed is my check in the amount of $ _________________
Make check payable to: Skyline Cycling Club
Mail to:
Skyline Cycling Club
P.O. Box 60176
Sunnyvale, CA 94088
For information on Skyline T-shirts, call Lorrayne Griffin at (408) 984-8791.