Almaden Cycle Touring Club
Untitled Document
ACTC Membership System
For NEW Nememberships
To apply for membership with the Almaden Cycle Touring Club complete the form below and click the Submit button.

Membership Application Type (Required) Dues are $25 per year for an individual, or $30 per year for a family.
Single or Family Number of Years Payment Method

Member Information (Required)
First Adult (include primary contact email and phone number)
First Name Last Name with the liability waiver
Primary Email Phone
Secondary Email Phone  

Second Adult (include primary contact email and phone number) - for family memberships only
First Name
Last Name with the liability waiver
Primary Email
Phone
Secondary Email Phone

Children - For Family Memberships Only
First Names
For families with children listed, you must complete and mail in a printed Waiver of Liability.

Street address
City
State ZIP Code -
Emergency Phone
Emergency Note

Additional Options
Black and Blue Bottom Newsletter  
Newsletter Delivery The monthly Newsletter is available online or by 3rd class postage. We encourage online delivery to save mailing costs and conserve resources. First Class postage is no longer available for new or renewing memberships, but will be honored for existing memberships.
Club Directory Options  
Include My Information in Club Directory - If Included show my Address Phone Email

 


Release and Waiver of Liability (Required)

Please read the waiver carefully: (printed version) . Each Adult must individually indicate their agreement above next to their name. For families with children, you must complete a paper Waiver of Liability form and provide to the Membership Chair

 


Comments (please do not use quotation marks or tabs, as these confuse our database)


Submit Application

Before clicking the Submit button below, you may wish to print this page for your records.

  Important: You must click on the Submit button after filling in this form or your information will not be sent!