Eclipse this Path Ride & Social - April 8th @ Crosstown Grille
x
We use cookies to enhance your browsing experience, serve personalized ads or content, and analyze our traffic. By clicking "Accept All", you consent to our use of cookies. Customize
If you are already a member, SIGN IN
SouthSide Cycling Club Membership Form
Notes for membership:
Trial memberships for one month may be only used once.
Returning members may only resume a trial membership for one month.
Family membership requires first a current paid individual membership, with the option to add up to three additional family members who must be either a spouse or dependent children under the age of 18 who reside in the same household and street address. You must first pay the sponsoring individual membership, then return to this form to add each additional family member.
First Name *
Last Name *
Email *
Password *
Confirm Password *
Categories *
   Single Rider Membership (1 Year) - $30.00
   Family Membership - $10 Each Additional Member (1 Year) - $10.00
   Welcome (1 Month Trial- May only be redeemed once, not valid for returning members.)
   Returning Members (1 Month - May only be redeemed once.)
Country *
Address *
City *
State *
Zip Code *
Phone *
Emergency Contact *
Emergency Phone *
I am a ... *
  New Member
  Returning Member

I am the family member sponsor
Family Membership Sponsors Name (Required) *
Waiver *
Read through the agreement

I have read and agreed to the TERMS *
Is the participant 18 or older? *
  18 or older       Under 18
Payment Details
Discount or Tracking Code
 
Apply
Do not COPY & PASTE the code, please type it into this field.
Price
$
Discount (-)
$
Handling
$
Total Owed
$


Payment Method
Visa/Mastercard
Credit Card #
Postal Code
Exp. Date  
/
CVV Code
Your payment is encrypted and 100% secure.
Club Management, Website and App powered by RaceReach.
G-DJJE5YEEGT