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Membership Information
Village CycleSport MTB Club

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Membership Application


Last Name:______________________________________First Name:___________________________Middle Initial:_________

Home Address:__________________________________City:____________________________State:_______Zip:__________

Home phone number:___________________________Work phone:________________________e-mail:__________________

Membership Type: New ($25)_____; Renewal ($15)_____; Under age 18 ($10)_____

Please do/do not add my information to the Club website. (Only phone numbers and e-mail addresses are listed on the Club website).

Memberships run from January 1 through December 31. Joining after September 30 continues your membership through the following year.

Please make checks payable to: VCS MTB Club, and mail, or drop off, along with this application to:

VCS MTB Club, c/o Village CycleSport, 45 Arlington Heights Road, Elk Grove Village, IL 60007

In consideration of being permitted to be a member of the Village CycleSport Mountain Biking Club and to participate in Club rides and events, including transportation to and from the same, I do hereby for myself, my heirs, executors, and administrators, RELEASE, WAIVE, and FOREVER DISCHARGE the Village CycleSport Mountain Bike Club, its officers and members, and the Village CycleSport Shop, its directors and employees from any and all claims, demands, actions, or the liabilities on account of any injury to me which may occur from any cause whatsoever, including negligence or other fault on the part of anyone released hereunder, during my participation in or transportation to or from said rides and events. I ACKNOWLEDGE THAT I AM AWARE OF THE RISKS AND HAZARDS INHERENT UPON ENGAGING IN SAID CLUB ACTIVITIES, AND I DO SO ENTIRELY UPON MY OWN INITIATIVE, RISK, AND RESPONSIBILITY. I FURTHER UNDERSTAND THAT THE CLUB DEPENDS UPON Its MEMBERS TO HELP IT PROVIDE AND LEAD CLUB ACTIVITIES AND THAT THOSE MEMBERS ARE RELYING ON THE PROTECTION AFFORDED HEREUNDER. I hereby further agree to operate my bicycle in a manner that is safe to me and to those around me, to observe all applicable safety regulations and to conduct myself in a manner that will be complimentary to the sport of bicycling. It is my intent that this RELEASE and WAIVER apply at all times, notwithstanding that my membership in the Village CycleSport Mountain Bike Club may have expired, lapsed, been renewed or been reinstated after a period or periods of non-membership. I FURTHER ACKNOWLEDGE THAT I HAVE READ THE FORGOING RELEASE AND WAIVER, UNDERSTAND IT, INCLUDING THE IT IS INTENDED TO COVER OCCURRENCES WHICH MAY NOT YET HAVE OCCURRED AND WHICH ARE UNKNOWN TO ME, AND NOTWITHSTANDING THE FORGOING, I SIGN IT VOLUNTARILY WITH THE FULL INTENT THAT IT BE FOREVER ENFORCEABLE.

Signature:____________________________________________________________,Age:_________,Today's Date:__________________.

Signature of legal guardian (if under 18):______________________________, Relationship:____________, Today's Date:_______________.