Single Membership

Price:

$15 for 1 year

First Name:* First Name Required

Last Name:* Last Name Required

Address Line 1:* Address Line 1 is Required

Address Line 2: Address Line 2 is not valid

City:* City is Required

Country:* Country is Required

State/Province:* State/Province is Required

Zip/Postal Code:* Zip/Postal Code is Required

I am at least 18 years old. (complete bottom portion if under 18 years old):* I am at least 18 years old. (complete bottom portion if under 18 years old) is Required

Yes I am at least 18 years old. I am a minor and my Parent/Guardian is signing below.

Name of parent or guardian if under 18:: Name of parent or guardian if under 18: is not valid

Email:* Invalid Email

Cash or Check

Please send your cash or check to:

Janesville Velo Club
P.O. Box 1601
Janesville, WI 53547

Note: This can take several weeks to be approved.

Credit/Debit Card

Pay via your PayPal account

I agree to the JVC Waiver (click here to read)*

No val Please fix the errors above