Stirling Bike Club Family Membership Subscription

Please complete all the fields and ensure the email address you enter is valid as this is used to confirm your membership and to activate your account.

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Username*

Password*

Retype Password *

First Name *

Surname *

Date of Birth (dd-mm-yyyy) *

Address *

Town *

Post Code *

Phone *

Email *

Any medical or disability information we need to be aware of, if so please let us know here

My main type of cycling is *

Mountain Biking

Road Biking

Gravel Riding

Cyclocross

Track

Bike Packing/Touring

BMX

Enduro/Down Hill

I also like...

Mountain Biking

Road Biking

Cyclocross

Gravel

Track

Bike Packing/Touring

BMX

Enduro/Down Hill

Name of Emergency Contact *

Emergency Contact Number (ICE) *

British Cycling Number (if applicable)

Please enter details of the second adult in the fields below

2nd Adult's first Name *

2nd Adult's Surname *

Date of Birth (dd-mm-yyyy) *

2nd Adults Phone number *

2nd Adult's Email Address

Any medical or disability information we need to be aware of, if so please let us know here *

My main type of cycling is *

Mountain Biking

Road Biking

Gravel Riding

Cyclocross

Track

Bike Packing/Touring

BMX

Enduro/Down Hill

I also like...

Mountain Biking

Road Biking

Cyclocross

Gravel

Track

Bike Packing/Touring

BMX

Enduro/Down Hill

Name of Emergency Contact *

Name of Emergency Contact *

____________________________________________________________________________________________________________________________________________________________

Here is the SBC Under 18's participating in "all age" activities Policy

I/We have read and agree to the above policy. This is mandatory (the form will open up to allow you to enter details of your family below once you have read and agreed to the policy) *

Tick to confirm agreement

____________________________________________________________________________________________________________________________________________________________

Please enter details of your first child in the fields below

1st childs first Name *

1st child's Surname *

Date of Birth (dd-mm-yyyy) *

Their main type of cycling is *

Mountain Biking

Road Biking

Gravel Riding

Cyclocross

Track

Bike Packing/Touring

BMX

Enduro/Down Hill

They also like...

Mountain Biking

Road Biking

Cyclocross

Gravel

Track

Bike Packing/Touring

BMX

Enduro/Down Hill

Want to add a 2nd child to your family membership, then please tick the box below

Tick here to add more details

____________________________________________________________________________________________________________________________________________________________

Please enter details of your 2nd child in the fields below

2nd childs first Name

2nd child's Surname

Date of Birth (dd-mm-yyyy)

Their main type of cycling is

Mountain Biking

Road Biking

Gravel Riding

Cyclocross

Track

Bike Packing/Touring

BMX

Enduro/Down Hill

They also like...

Mountain Biking

Road Biking

Cyclocross

Gravel

Track

Bike Packing/Touring

BMX

Enduro/Down Hill

Want to add a 3rd child to your family membership, then please tick the box below

Tick here to add more details

____________________________________________________________________________________________________________________________________________________________

Any medical or disability information we need to be aware of, if so please let us know here

Please enter details of your 3rd child in the fields below

3rd childs first Name

3rd child's Surname

Date of Birth (dd-mm-yyyy) *

Their main type of cycling is *

Mountain Biking

Road Biking

Gravel Riding

Cyclocross

Track

Bike Packing/Touring

BMX

Enduro/Down Hill

They also like...

Mountain Biking

Road Biking

Cyclocross

Gravel

Track

Bike Packing/Touring

BMX

Enduro/Down Hill

Want to add a 4th child to your family membership, then please tick the box below

Tick here to add more details

____________________________________________________________________________________________________________________________________________________________

Please enter details of your 4th child in the fields below

4th childs first Name *

4th child's Surname *

Date of Birth (dd-mm-yyyy) *

Their main type of cycling is *

Mountain Biking

Road Biking

Gravel Riding

Cyclocross

Track

Bike Packing/Touring

BMX

Enduro/Down Hill

They also like...

Mountain Biking

Road Biking

Cyclocross

Gravel

Track

Bike Packing/Touring

BMX

Enduro/Down Hill

Want to add a 5th child to your family membership, then please tick the box below

Tick here to add more details

____________________________________________________________________________________________________________________________________________________________

Please enter details of your 5th child in the fields below

5th childs first Name *

5th child's Surname *

Date of Birth (dd-mm-yyyy) *

Their main type of cycling is *

Mountain Biking

Road Biking

Gravel Riding

Cyclocross

Track

Bike Packing/Touring

BMX

Enduro/Down Hill

They also like...

Mountain Biking

Road Biking

Cyclocross

Gravel

Track

Bike Packing/Touring

BMX

Enduro/Down Hill

Want to add a 6th child to your family membership, then please tick the box below

Tick here to add more details

____________________________________________________________________________________________________________________________________________________________

Please enter details of your 6th child in the fields below

6th childs first Name *

6th child's Surname *

Date of Birth (dd-mm-yyyy) *

Their main type of cycling is *

Mountain Biking

Road Biking

Gravel Riding

Cyclocross

Track

Bike Packing/Touring

BMX

Enduro/Down Hill

They also like...

Mountain Biking

Road Biking

Cyclocross

Gravel

Track

Bike Packing/Touring

BMX

Enduro/Down Hill

____________________________________________________________________________________________________________________________________________________________

Additional Children, not a problem. Please enter their name(s) and DoB(s) below

Additional Children's details including any relevent medical information that a ride organiser may need if any of your children attends one of the main club's organised rides (NOTE : As per our U18 policy additional permissions are required for this)

____________________________________________________________________________________________________________________________________________________________

Primary Emergency Contact person for your Child(ren) *

Primary Emergency Contact Number for your children *

____________________________________________________________________________________________________________________________________________________________

Secondary Emergency Contact person for your Child(ren)

Secondary Emergency Contact Number for your child(ren)

____________________________________________________________________________________________________________________________________________________________

Payment Information

Price

£

Payment Method

Paypal

Credit Card Number*

Expiration Date*

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Card (CVV) Code*

Card Holder Name*

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Stirling Bike Club Family Membership Subscription

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