Test-Membership

Please complete the form below to register as a member of the Sydney Muslim Cyclists.
All memberships run on a 2 year period and will all renew in 2023.

Member Details

First Name *

Last Name *

Email *

Mobile Phone *

Street Address *

City *

State *

Post Code *

Date of Birth

d/m/Y

Emergency Contact Name *

Emergency Contact Phone *

Membership Option

Please choose the option for the 2 year membership

Membership Option *Membership

Jersey Size *Select your jersey size

Shorts SizeSelect your shorts size

Wind Vest SizeWind Vest Size

Wind Jacket Size Wind Jacket Size

Winter Vest Size Winter Vest Size

Intermediate Winter Jersey Size Intermediate Winter Jersey Size

Optional Clothing

Purchase additional items of clothing

Performance Winter Jersey Size Performance Winter Jersey Size

Optional Clothing *Select one or more items

Jersey Size *Select your jersey size

Shorts Size *Select your shorts size

Wind Vest Size *

Wind Jacket Size *Wind Jacket Size

Winter Vest Size *Winter Vest Size

Intermediate Winter Jersey Size *Intermediate Winter Jersey Size

Performance Winter Jersey Size *Performance Winter Jersey Size

Credit / Debit Card *

CC Surcharge *AgreeDo not agreeDo you agree to pay 2.5% surcharge

Coupon

Checkbox *Apply Discount

Postage *Postage - $14.95Pick UpIf you would like your items posted to your address, please select Postage.

Membership Total