Cycling enthusiasts, friends or sponsors may become members by paying $5.00 plus 46 cents for Paypal fee (if applicable) per year. Membership entitles you to be member of USDCA and a subscriber to the eBreakaway newsletter.

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First & Last Name: 

Address: 

City:   State:   Zip: 

Visual Phone Number: 

E-mail Address:   (Required to fill)

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Please check your current membership  

(a) Renewal  New  Renewal after several years

(b) Competition  Recreation  Coach  Sponsor  Friend  Organization

(c) Which of the following information fits you:

just want to keep myself fit and well just want to social and be active am an active racing cyclist would like to become a racing cyclist someday just want to keep myself informed about the cycling world am supportive because my friends are active CDW member none of the above, see my comment below

Stop Here and submit your membership application at the bottom. Thank you

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For those who are interested in race and/or be on the team, please fill the blanks below:

Are you a racing cyclist?   Yes  No

What bike type?     Mounatin  Road  Both

Male   Female

Weight:    Height:    Birthdate:  e.g. 00-00-0000

School:   

College: 

Occupation: 

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United States Cycling Federation:   Yes  No    

Class:  Junior  Senior  Master 

Category:  5  4  3  2  1 

Cycling Club: 

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NORBA:   Yes  No

Cross Country Category:  Beginner Sport Expert Elite Pro

Mountain Bike Club: 

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Please comment if any question about this application or others given below:

   

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