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2008 Heart of Ohio Tailwinds Membership |
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MAIL FORM TO: HEART OF OHIO TAILWIND BIKE CLUB PO Box 176 MARION OH 43301-0176 |
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Please print this application on your browser and mail to the address at the bottom of the page. Please complete the application and sign the release for all members of the family who wish to join. Signature of parent or guardian is required for each child under the age of 18 years.
By signing this release for myself or for the applicant under 18 years of age, I understand and agree to absolve all Heart Of Ohio Tailwinds Bicycle Club members, sponsors, organizers, and associated entities singly and collectively of all blame for any injury, misadventure, harm, loss, or inconvenience suffered as a result of taking part in any of the activities or gatherings of the Heart Of Ohio Tailwinds Bicycle Club.
Print Name Birth Date Signature
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Date Of Signature(s): (Mandatory)
Address:
City: State: Zip:
Phone: e-mail Address:_________________
Please Check All that apply:
New Member[ ] Renewal[ ] New Rider[ ]
I would be willing to help with:
Ride Leader or Routes[ ] HOT TAMALE Ride [] Other:
All memberships expire December 31 of each year.
Dues: Individual: $5 Married Couple $8 Family $10
*Amount Paid $
Payable to Heart Of Ohio Tailwinds Bicycle Club. |