Membership Application

Online Application Form


Medical



Membership Fees


*Born before 1961
Terms & Conditions Apply. Marketing Opportunities available.

Bank: Standard Bank
Account Name: Rustenburg Cycling Club
Account Number: 27 249 806 8
Branch Code: 052646

Payment Reference: M-Name and Surname (eg. M-Bob Sinclair)
Click or drag a file to this area to upload.

Please note the following

  • All 2020 CSA Membership fee's must be paid directly to CSA plus North West Affiliation Fee
  • All Applications forms must be submitted together with proof of payment.
  • Corporate Members to attach Companies Proof of Payment as well as a Company Letterhead with members Company numbers.
I/We accept the terms and conditions of the personal indemnity published on the website of the Rustenburg Cycling Club (www.rustenburgcycling.co.za) . I/We the undersigned furthermore accept and agree that neither Rustenburg Cycling Club, nor the sponsors shall be held liable under any circumstances, for any injury or damage that I/we may suffer during, in connection with, or as a result of my membership and association with the club, club rides and events planned and hosted. I/We the undersigned accept and agree that Bergheim Holiday Resort (Bergheim Trails/associated land owners) is used entirely at my/our own risk and that Bergheim Holiday Resort (Bergheim Trails/assocaited land owner) shall not be held liable in any way for injury or damage sustained on their premises or the trails provided. I /We also agree to abide by the rules of club and events, and ride in a manner which is safe to me and others. I/we also declare that the bicycle that I will ride in the events is in good working order and will be properly maintained.