Henry County Bike Club Membership Form

Teenagers to retirees are members of our club! Members receive discounts on club jerseys, other HCBC merchandise and are added to our private email list. Dues are for each calendar year beginning in January. (No prorating of yearly dues). We look forward to riding with you soon!

Fields marked with * are required.

Membership Dues
Annual Membership Dues: $10 Individual or $15 for complete family
How many family members are you registering?
(not including yourself) *		  
Select which method you wish use to pay your membership dues: Paypal Check
 
Member Information
First Name *
Last Name *
Address *
City *
County *
State *
Zip *
Phone * - -

Please enter a unique username for your forum account.
UserName *

Please enter a password for your user account.
Password *
Confirm Password *

Please enter a valid email address for yourself.
Email Address *
Confirm Email *
verification code *

Please type in verification code
 
Additional Information
Select your principle ride class *
(Class specifications)
How did you hear about us?
Are you interested in organizing or leading rides?
 
Assumption of Risk/Waiver of Claim

I wish to participate in recreational activities offered by the HCBC.  I understand that the above-mentioned program involves activity that can be both strenuous and physically demanding and could result in my being physically injured.    I assume all risk of any physical injury or other loss that I might sustain as the result of participating in this activity.  I further assume any risk during travel to and from the area where the activity will take place.

I understand the importance of following all rules and regulations relating to this activity including obeying traffic regulations and the ride leaders’ requirements for the organized rides/activities.  I have and will wear my helmet while operating my bicycle at all times!

I have read this waiver and release and discharge the HCBC, its officers, ride leaders and other volunteers from all claims for injury, property damage or death from participating in any HCBC sponsored event.  I further certify that I’m in good physical condition and my bike and helmet are safe to operate and properly worn.
 


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