Club Cycleweb.co.uk Application Form

Print out this form, complete and then send to the address as given below.

Name  
Address  
   
   
   
Post Code  
   
Telephone Number  
Email  
   
Date of Birth (if under18 yrs)  
   
Free Jersey size XS - S - M - L - LX
Interested in racing? Yes / No - (if yes Road or MTB?)
Interested in race support team? Yes / No - (if yes Road or MTB?)
Do you wish to be informed of Club Special Offers? Yes / No

After completing the form please send to the address below together with a cheque for £25 made payable to Multimedia I.T. Ltd

Send to:

Please note that the free replica team jerseys will be despatched as soon as the full team partnership details are confirmed. Apologies for any delays that this may cause at the beginning of the season.

All details given on this form will be treated as confidential