Membership Application

Name (Mr. / Ms. / Mrs.): _________________________________ Birth date: _____________

Family members/ ages: _________________________________________________________

Address: _____________________________________________

City: _____________________________ State: ______________ Zip: ______________

Phone: (____) _____________________

E-mail Address: ______________________________________________________

Please circle type of membership:

Individual - $15.00 Family - $20.00

Do you wish to have your name, address and telephone number published in the Sweet Onion Cyclists directory? (__) Yes (__) No

In consideration of my membership, I agree not to hold the Sweet Onion Cyclists, or any of its members liable for any injury or damage, however caused, which may result from participation in any event sponsored by the club. Furthermore, I pledge to abide by Georgia law and ride in accordance with the standards of courtesy and safety as subscribed by the club.

Signature: ____________________________ Date: _____________ (Parent if under age 18)

IMPORTANT: Please print and complete Questionnaire and send with application.

Mail to:

Lamar Martin, Sweet Onion Cyclists, 277 Dove Drive, Vidalia, GA 30474