Join Us

Name:
Address:
Postcode:
Email:
Phone:
DOB:

Emergency Contact
Name:
Address:
Phone:
Relationship:

Are you joining Evesham Wheelers as a 1st claim club member?: YesNo
If not, please give 1st Claim Club:

Third Party Insurance No:
You must have a valid third party insurance policy to participate in Club Rides.
These are usually included with memebership to British Cycling or Cycling UK.

What is 2 + 2?

By submitting this form, you wish to apply / renew your Evesham Wheelers membership and agree to abide by the rules of the club.

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