STOUFFVILLE BMX 2017 Membership
STOUFFVILLE BMX 2017 Membership STOIJFFVILLE BMX: @ BRUCE'S MILL
Complete this Application and the BMX CANADA Membership Application (if necessary) Send to: Stouffville BMX, 63 James Ratcliff Ave., Stouffville, ON L4A 1 P3 Please include a cheque payable to Stouffville BMX
ENJOY THE RIDE
RIDER INFORMATION Name:
Phone: (Please Print Clearly)
City: Postal:
Province:
D.0.B
Email: (mm/dd/yyyy)
(No private contact information will be shared or provided to any sponsors or partner of Stouffville BMX.)
Fees
Select Membership Type(s) - Select each that apply [ ] Full Stouffville BMX Membership Includes: Single Point Races, Practices
$ 195.00
[ ]
Second Family Member
$ 170.00
[ ]
Third or more Family Member
$ 145.00
[ ] Second Bike (for existing SBMX members)
I
I
TOTAL
$ 75.00 $
Consent
No one except riders officially entered in the event may ride or practice on any portion of the track during a sanctioned event. All appropriate waivers must be fully signed prior to riding the track. All riders must hold a valid BMX CANADA license at all times and may be required to prove verification. All riders must wear the appropriate safety equipment consisting of long sleeved shirt, long pants, closed toe shoes and helmet (full-face helmet recommended) while on the track. Number plates must be clearly visible and secured on all bikes. All riders must ensure that their bike is in safe condition prior to being permitted to operate the bicycle on the track. A track official may verify the safety of the bike prior to racing. Riders are required to understand the rules which can be found on the BMXCanada.org website.
If the rider is under 18 years old, parent/legal guardian signature is required. Rider's Name or Guardian Name
Signature Date: _______, 2017
A $25.00 charge will apply for an NSF cheque and the rider will not be eligible to race until the amount is paid in full in cash, including the NSF charge.
*******************************************************************************************************************************'************
Receipt
Membership Type(s):----------------------Amount Paid:------------
Date:-----------
Want to volunteer? Ask us how to get involved. Send this Application and the BMX Canada license form (if applicable) with a cheque to: Stouffville BMX 63 James Ratcliff Ave., Stouffville, ON, L4A 1 P3
www.stouffvillebmx.ca
Complete this Application and the BMX CANADA Membership Application (if necessary) Send to: Stouffville BMX, 63 James Ratcliff Ave., Stouffville, ON L4A 1 P3 Please include a cheque payable to Stouffville BMX
ENJOY THE RIDE
RIDER INFORMATION Name:
Phone: (Please Print Clearly)
City: Postal:
Province:
D.0.B
Email: (mm/dd/yyyy)
(No private contact information will be shared or provided to any sponsors or partner of Stouffville BMX.)
Fees
Select Membership Type(s) - Select each that apply [ ] Full Stouffville BMX Membership Includes: Single Point Races, Practices
$ 195.00
[ ]
Second Family Member
$ 170.00
[ ]
Third or more Family Member
$ 145.00
[ ] Second Bike (for existing SBMX members)
I
I
TOTAL
$ 75.00 $
Consent
No one except riders officially entered in the event may ride or practice on any portion of the track during a sanctioned event. All appropriate waivers must be fully signed prior to riding the track. All riders must hold a valid BMX CANADA license at all times and may be required to prove verification. All riders must wear the appropriate safety equipment consisting of long sleeved shirt, long pants, closed toe shoes and helmet (full-face helmet recommended) while on the track. Number plates must be clearly visible and secured on all bikes. All riders must ensure that their bike is in safe condition prior to being permitted to operate the bicycle on the track. A track official may verify the safety of the bike prior to racing. Riders are required to understand the rules which can be found on the BMXCanada.org website.
If the rider is under 18 years old, parent/legal guardian signature is required. Rider's Name or Guardian Name
Signature Date: _______, 2017
A $25.00 charge will apply for an NSF cheque and the rider will not be eligible to race until the amount is paid in full in cash, including the NSF charge.
*******************************************************************************************************************************'************
Receipt
Membership Type(s):----------------------Amount Paid:------------
Date:-----------
Want to volunteer? Ask us how to get involved. Send this Application and the BMX Canada license form (if applicable) with a cheque to: Stouffville BMX 63 James Ratcliff Ave., Stouffville, ON, L4A 1 P3
www.stouffvillebmx.ca
