Kalamazoo Bicycle Club - Membership Application

Membership Type
Adult Membership: one year - $15 three year - $40 (save $5)
Family Membership: one year - $17 three year - $45 (save $6)
Senior Membership: one year - $13 three year - $35 (save $4)

Member Information
New membership      Renewal
Member Name
Date of Birth
Address
City
State
Zip
Phone #
E-Mail

Immediate Family Member Names (family memberships)
Name Dates of Birth

Signature _________________________________
Parent's Signature (if under 18) ______________________________________

Are you interested in working KBC Events? Yes    No

Rider category: Fitness     Casual     Competitive

Please fill out and mail to:
Kalamazoo Bicycle Club
PO Box 50527
Kalamazoo MI 49005