2010 Club Application Form

Information for ABA Website
Club Name:
Contact Name:
Contact Email:
Contact Phone:
Club Website:
Main Club Sponsors:
Club Jersey Colors:
Jersey Design: Please enclose a photograph or sketch of your team jersey if your club is affiliating for the first time. Submit to Info@albertabicycle.ab.ca
Please Check All That Apply:
	Road
	Track
	MTB
	Cyclo-cross
	DH/4H
	BMX
	Touring
	Trail Access
Club President
First Name
Last Name
Email address
Address
City
Country
Prov/State
ZIP/Postal Code
Phone (h)
Alternate Phone
Fax
Club Treasurer or Track Operator
First Name
Last Name
Email address
Address
City
Country
Prov/State
ZIP/Postal Code
Phone (h)
Alternate Phone
Fax
Declaration On Acceptance as a club of both the provincial cycling association and Canadian Cycling Association, the applicant agrees to abide by the rules, regulations and procedures of the Alberta Bicycle Association and Canadian Cycling Association. I agree to submit all names of members of the club and have each member sign the ABA insurance waiver. I agree to pay the insurance for each of these members.
Have you read and do you agree to the terms and conditionas above?
Yes
No
Club President Full Name
Date	//