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B.C. Masters Cycling Association Membership Application for 2008
(Racing is for members only who are 30 years or older)
O Annual Racing Membership in BCMCA -- $30
O Race Day Membership, available race days only (Gives you a chance to try our racing without buying a full membership).-- $5 per day
O Annual Associate Membership in Cycling BC (You don't need this category if you are already a Cycling BC Member or have a full racing license.) It's mandatory. It provides accident and liability insurance while racing. Info at 604-737-3034) -- $35
Cheques payable to: BCMCA, c/o 766 Handy Road, Mill Bay, BC, V0R 2P1
(B.C. Masters Cycling needs volunteers. If you can help, call Bill Yearwood 604 267-7338)
Please print the following information, sign the first waiver (below) and return it to the above address. Applicants who don't plan to get a race license (UCI or Citizen) must also sign the BC Cycling waiver and include it with your BCMCA application submission.
Name (last name first) __________________________________________________________
Address (incl. postal code)_________________________________________________
Home Phone ___________________ Work Phone ___________________
Fax ____________________ E-mail _________________
Date of birth ________ Age this year ________ Category ________
e.g. Male 30-34, M 35-39, M 40-44, etc; Female 30-34, F 35-39, F 40-44, etc.
Note: Your age for category purposes is whatever age you attain in 2008.
If you would like to volunteer to help at races, please check here
BCMCA WAIVER, SAFETY AFFIRMATION AND RELEASE
(Must be signed with membership application)
In consideration of the acceptance of this membership application and of being allowed to participate in The B.C. Masters Cycling Association activities, I hereby personally assume all risks in connection with those activities and I further agree to forever release, discharge, waive, save and hold harmless the B.C. Masters Cycling Association, the Activity Leaders, and any Agents from any claim by me, or by my family, estate, heirs or assigns arising out of my participation in these activities. This includes, but is not limited to, waiving any and all rights, demands, or claims for damages and causes for suits or actions known or unknown, and further includes but is not limited to medical expenses or other expenses in the event of accident, illness, other incapacity, death or damage to property. I further state than I am of lawful age and legally competent to sign this Affirmation, Waiver and Release. I understand that the terms of this document are contractual and not a mere recital and I have signed this document as my own free act. I attest and verify that I have full knowledge of the risks involved in participation of Club activities. I agree to obey the rules of the road and racing, to act in a courteous manner towards other road users in a spirit of goodwill and co-operation, and that my failure to do so will result in my disqualification and/or loss of membership. I understand I need my own liability coverage. I have fully informed myself of the contents of this Affirmation, Waiver, Release by reading it before signing below.
Signature_______________________________________ Date____________________
(Space below for office use only)
RACE NUMBER ______________ Paid By: ___________ CBC Associate Member? ____
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