Membership Application and Renewal Membership Application Type(required)New ApplicationRenewalFirst name(required)Last Name(required)Address(required)Town/Suburb(required)Post Code(required)Mobile Number(required)Email address(required)Emergency Contact Name(required)Emergency Contact Mobile(required)Membership Payment Payment should be made directly to the Club via Direct Credit from your bank account. MRCC bank account details: Account Name: Macedon Ranges Cycling Club Inc BSB: 633 000 Account Number: 129561718Insurance Details All members must hold insurance through either Auscycling or Bicycle Network. If you have equivalent cycling insurance through another organisation please email the details to macedonrangescyclingclub@gmail.com.Insurance(required)AuscyclingBicycle NetworkOther Cycling InsuranceMembership NumberMembership Category(required)AdultFamilyJuniorAssociateVerify Age(required)I am aged 18 years or over.Number of Additional Family Members(required)1234Additional Family Member 1First Name¹(required)Last Name¹(required)Mobile number¹(required)Email address¹(required)Insurance¹(required)Cycling Victoria/AustraliaBicycle NetworkOther Cycling InsuranceMembership No.¹Additional Family Member 2First Name²(required)Last Name²(required)Mobile Number²(required)Email address²(required)Insurance²(required)Cycling Victoria/AustraliaBicycle NetworkOther Cycling InsuranceMembership No.²Additional Family Member 3First Name³(required)Last Name³(required)Mobile Number³(required)Email address³(required)Insurance³(required)Cycling Victoria/AustraliaBicycle NetworkOther Cycling InsuranceMembership No.³Additional Family Member 4First Name˜(required)Last Name˜(required)Mobile Number˜(required)Email address˜(required)Insurance˜(required)Cycling Victoria/AustraliaBicycle NetworkOther Cycling InsuranceMembership No.“Company Name(required)Junior Membership is for Club Members aged 17 years and under. *Membership must be approved by a parent or guardian. *Junior members must be accompanied by an adult on Club rides except for rides specifically for JuniorsDate of Birth(required)Parent/Guardian First Name(required)Parent/Guardian Last Name(required)Parent/Guardian Mobile Number(required)Parent/Guardian Email address(required)Associate members are non riding members If not a member of C.A or Bicycle Victoria, Associate members can type "Associate" into membership number box in the Insurance section. Terms and Conditions of Membership of the Macedon Ranges Cycling Club In becoming a member of Macedon Ranges Cycling Club you are agreeing to the Club’s Terms and Conditions which can be found at the following link https://macedonrangescycling.org.au/terms-and-conditions/ By clicking on the check box below: I/We declare that I/we have read and understood the Terms and Conditions of MRCC Membership. I/We Agree(required) When you click on the Send button below, your form will be emailed to the Club.I will be paying by the following method.(required)Direct Credit from my bank accountEmail address(required)UntitledUntitledSend Like this:Like Loading…
