Name (Mr. / Ms. / Mrs.): _________________________________ Birth date: _____________
Family members/ ages: _________________________________________________________
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.
Lamar Martin, Sweet Onion Cyclists, 277 Dove Drive, Vidalia, GA 30474