Membership Form

Your Name (required)

Date of Birth

Address




Post Code

Telephone

Mobile

Your Email (required)

British Cycling Membership No.

Emergency Contact Name

Emergency Contact Number

I Consent to Beverley Knights sharing this contact number with all fellow club members for use in an emergency
Note: Beverley Knights do not share your details with any third parties

I have read and will abide by the club rules

Enter the characters you see above

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