Membership Application

To join HoCo Cyclists or renew your existing membership in the club, please complete this form and read and sign the club’s liability waiver and release. Then, click the “Proceed to Payment” button. Note: If you already have paid your annual dues and need only to complete a liability waiver form, please go to this page.

Please choose one:(required)

New Membership ($20) Renewal Membership ($20)

First Name

Last Name

Email Address

Address 1

Address 2

City

State

Postal Code

Home Phone Number

Work Phone Number

Mobile Phone Number

What is your average riding pace?

How did you find us?

Emergency Contact

First Name

Last Name

Phone Number

Relationship

Liability Waiver

Carefully read this release and waiver of liability form and indicate your agreement:

By checking this box, I agree to the Howard County Cyclists Inc. Release and Waiver of Liability, Assumption of Risk, and Indemnity and Parental Consent Agreement and confirm that I am at least 18 years old.

Signature (type your full name)

Date (YYYY-MM-DD)