Join SRC Online

You can apply on-line to join Swindon Road Club and your details will be sent automatically to our club membership secretary. All you then need do is send your membership fees to the club secretary via a cheque made out to Swindon Road Club. The address to send cheques to is:- >

Name *

Address *

Email Address *

Date of Birth *

Telephone No. *

Occupation (Optional)

Type of Membership * First Claim Second Claim

Name of First Club

Only complete "Name of First Club" if you are joining as a second claim

Your Cycling interests (please check all that apply)

Road Racing

Time Trialling

Mountain Biking

Cyclocross

Triathlons & Duathlons

Track

Other (please state)

Membership Fees

Membership Fees * Family (All at same address) £21.00 Senior (19+ yrs) £15.00 Junior (16yrs to 18yrs) £8.00 Junior (under 16yrs) FREE Second Claim £7.00

Emergency Contact Details

Emergency Contact Name *

Emergency Contact Number *

Please detail below any important medical information that our club/coaches should be aware of (eg. epilepsy,asthma,diabetes etc..) Also recommended treatments & actions to be taken if symptoms appear

Medical Information