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ACTC Membership Application
For New Membership and Renewal Membership

The Almaden Cycle Touring Club is a group of cycling enthusiasts with a wide range of abilities. Emphasis is on group fun and safety, with a variety of bicycling events. A newsletter is published each month with a schedule of rides and club announcements.

Dues are $20.00 per year for an individual and $25.00 per year for a family. If first class delivery of the newsletter is required please remit an additional $12.00 per year for postage. If you prefer to get the Black and Blue Bottom newsletter online and do not want to receive a printed copy please check the appropriate box on your application.

Payment can be made either online using a credit card or you can mail a check. After you complete and submit the registration form below, you will be shown how to make payment.

 
Existing Members ONLY
Current members can get an email of their current membership data by completing the information below.

Last Name

E-mail   

To apply for membership with the Almaden Cycle Touring Club, or to renew your current membership, complete the form below and press the Submit button .To make any changes to a current membership or with other questions, contact ACTC Membership at membership@actc.org.

Member Information (Required)
Single or Family New or Renewal Number of Years Payment Method

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 Memberhsips Only
First Name
Last Name with the liability waiver
Primary Email
Phone
Secondary Email Phone  
Chidlren - For Family Memberships Only
First Names
For families with children listed, you must complete a paper 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, when requested below, is sent by mail. If you request to receive by bulk rate (3rd class) postage there is no additional charge. If you wish to receive by First Class Postage there is an additional $12 a year charge..
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: (version for printing) . 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 these fields or your information will not be sent!