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UMCA Membership Form
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** OTHER **
other:
Yes
No
May we publish your address, e-mail and telephone in the membership directory? The membership directory is ONLY published in the
UltraCycling
magazine. The information is not published on line or given to other organizations.
Yes
No
Racing in RAAM 2010? RAAM riders receive a copy of the crewing handbook:
Crewing with Fuzzy.
Membership
UltraCycling
magazine is sent to US members at the special Not-For-Profit rate and is sent Airmail outside the US; hence, the higher membership fees.
For family membership, select type (below) and the number of members (including yourself):
2
3
4
Select type of membership*:
USA
Canada
All Others
Membership fee:$
18 months (7/09 - 12/10):
$50
$65
$80
2010 Annual
$35
$45
$55
2010 Annual Family:
$50
$65
$80
Two Years 2010 & 2011:
$65
$85
$105
Two Years Family:
$95
$115
$135
Three Years:
$95
$125
$155
Three Years Family:
$140
$170
$200
2010 One-Weekend:
event*:
** OTHER **
** select member type **
ADK - 10
Balltown - 10
Calvins - 10
Central Europe - 10
Davis 12/24 - 10
Desafio - 10
Fireweed - 10
Hoodoo 500 - 10
HoS - 10
Ireland - 10
Metamora - 10
Official - 10
Radmarathon - 10
RAO - 10
Record Attempt - 10
Saratoga 12/24 - 10
Sebring - 10
Slovenia - 10
Tejas - 10
UltraMW - 10
** OTHER **
$10
$14
$14
2010 Crew (six month):
$20
$30
$40
Participation
Year-Rounder
:
$10 to cover awards
Ultracycling Cup
:
$10 to cover awards
Participation Fees: $
Family Member #1:
Family Member #2
Last name*:
Gender*:
Male
Female
First name*
(
middle optional
):
Birthdate*:
mm
dd
yyyy
E-mail:
Phone:
Year-Rounder:
$10 to cover awards
Ultracycling Cup:
$10 to cover awards
Participation Fees: $
Family Member #3
Last name*:
Gender*:
Male
Female
First name*
(
middle optional
):
Birthdate*:
mm
dd
yyyy
E-mail:
Phone:
Year-Rounder:
$10 to cover awards
Ultracycling Cup:
$10 to cover awards
Participation Fees: $
Family Member #4
Last name*:
Gender*:
Male
Female
First name
(
middle optional
)*:
Birthdate*:
mm
dd
yyyy
Email:
Phone:
Year-Rounder:
$10 to cover awards
Ultracycling Cup:
$10 to cover awards
Participation Fees: $
Jersey
USA $65 ea Outside USA $70 ea
Jerseys and Windbreakers
are in stock.
Man's (Chest):
S
(35-37)
M
(38-40)
L
(40-42)
XL
(42-44)
XXL
(44-48)
qty:
0
1
2
3
4
5
0
1
2
3
4
5
0
1
2
3
4
5
0
1
2
3
4
5
sold out
Woman's (Bust):
S
(32-34)
M
(34-36)
L
(36-38)
XL
(39-41)
qty:
sold out
sold out
0
1
2
3
4
5
0
1
2
3
4
5
Jersey: $
Windbreaker
USA $70 ea Outside USA $75 ea
Unisex (Chest):
S
(35-37)
M
(38-40)
L
(40-42)
XL
(42-44)
qty:
0
1
2
3
4
5
0
1
2
3
4
5
0
1
2
3
4
5
0
1
2
3
4
5
Windbreaker: $
Tax-deductible Contribution
The UMCA is a not-for-profit educational organization.
$
Contribution: $
Total Fees
Total fees: $
Special Instructions
Checkout
Click checkout to review charges, select payment type (mail-in check or credit-card via Paypal) and register.
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