Membership Part One

Part One: Fill out the form below. Upon Submit, you will be redirected to our payment page where you can choose the level of membership and pay via PayPal.

Individual Membership, yearly: $27.00
Joint (Family) Membership, yearly: $42.00
Joint Membership with bikePGH yearly: $42.00
Lifetime Membership: $500

New Members & Renewing Members
New or Renewal (choose one) *

New Member Renewing Member
Name *

First

Last
Email Address *
Full Address

Street, City, Zip
Phone

(000) 000-0000
Date of Birth

00/00/0000
Years in the Saddle
Bikes You Ride (road, mountain, hybrid, other)
Would You Like to Lead Rides?

Yes No
Referred By:
Joint (Family) Membership

Spouse, Partner or Significant Other for Joint Membership
Joint Member Name

First

Last
Joint Member Email Address
Emergency Contact Info
Emergency Contact Name *

First

Last
Emergency Contact Full Address

Street, City, Zip
Emergency Contact Phone *

(000) 000-0000
Comments

Be patient, please. Upon Submit, you will be redirected to a page with membership and payment options. This can take as long as 15 seconds – we know it’s pokey, but it works! Thanks for your patience!

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New Members & Renewing Members

Joint (Family) Membership

Emergency Contact Info

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