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New Member Registration

Please take a moment to fill out this form with your General Information.

Register

Are you a member?

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Full Name *

First Name Last Name
Gender

Male Female
Birth Date *

Month Day Year
Nationality *

Contact Information

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E-mail
example@example.com
Phone Number *

Area Code Phone Number
Pickup Address

Street Address

Street Address Line 2
Country
Upload a recent photo of yourself

Passport size photo (Good quality please)
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(ID or birth certificate) Passport size photo
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CLASS

Only competitive, recreational and commuter riders are covered by accident insurance. Select recreational or commuter rider if you are a technical official who also rides.
Select class:

Competitive Commuter Recreational Technical Member (Mechanics & Coaches)

Choose Category

In order to register as a junior/master or any other age guided category, please calculate your age as at December 31 of the year of registration. (Eg. If you are born 2002, your age for 2020 is 18, regardless of your exact date of birth.)
Choose Category:

Category 1 Category 2 Category 3 Category 4 Category 5 Female Open Master (40 years & over) SuperMaster (50 years & over) Junior Male (16-18 years) Junior Female (16-18 years) Juvenile (under 16 years)

DISCIPLINE:

Select any or all of the disciplines you participate in.
Choose Category:

ROAD TRACK MTB BMX PARA TRIALS CYC4ALL CYCLO-X ATHLETE

Cyclist Signature here

Clear

Guardian's Information:

Guardian's signature required if the applicant is under 18 years of age
Guardian's Name

First Name Last Name
Guardian's Signature here

Clear
Guardian's Relationship
Should be Empty:

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Re-Registration

Please take a moment to fill out this form with your General Information.

Register

Full Name *

First Name Last Name
Gender

Male Female
Birth Date *

Month Day Year
Nationality *
Contact Information

We are almost there, please continue.
E-mail
example@example.com
Phone Number *

Area Code Phone Number
Pickup Address

Street Address

Street Address Line 2
Country
Upload a recent photo of yourself

Passport size photo (Good quality please)
Cancel of
Upload proof of age

(ID or birth certificate) Passport size photo
Cancel of
CLASS

Only competitive, recreational and commuter riders are covered by accident insurance. Select recreational or commuter rider if you are a technical official who also rides.
Select class:

Competitive Commuter Recreational Technical Member (Mechanics & Coaches)
Choose Category

In order to register as a junior/master or any other age guided category, please calculate your age as at December 31 of the year of registration. (Eg. If you are born 2002, your age for 2020 is 18, regardless of your exact date of birth.)
Choose Category:

Category 1 Category 2 Category 3 Category 4 Category 5 Female Open Master (40 years & over) SuperMaster (50 years & over) Junior Male (16-18 years) Junior Female (16-18 years) Juvenile (under 16 years)
DISCIPLINE:

Select any or all of the disciplines you participate in.
Choose Category:

ROAD TRACK MTB BMX PARA TRIALS CYC4ALL CYCLO-X ATHLETE
Should be Empty:

Now create your own JotForm - It's free! Create your own JotForm

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