NAME ...............................................

ADDRESS .............................................

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TELEPHONE .........................................

CLUB ......................................................

I am interested in Road Racing

(please tick) Time Trialling

M.T.B

Leisure

Track

MEMBERSHIP FEES

Please tick

Juvenille ( 14 - 16)    [   ]    £3.50

Junior    ( 16 - 18)    [   ]     £4.50

Senior    ( 18 +)        [    ]    £6.00

Senior Social    ( 25+)    [   ]     £3.00

Please Print this Page and send, with a cheque made payable to Luton Arrow CC, to.... Membership Secretary

David Anderson

13 Woodford Road, Dunstable, Beds, LU5 4JS