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MEMBERSHIP FORM

Name of Application: _________________________________ Nickname: ____________

Date of Birth: ___________________ Age: __________ Gender: __________________

Address: _________________________________________________________________

_________________________________________________________________

Mobile No.: ____________________ Email: ___________________________________

Present Occupation: _________________________ Position: ______________________

Contact Person in case of Emergency: _________________________________________

Contact No.: ______________________ Relation to contact: ______________________

How did you know about the group: ___________________________________________

Other MTB Groups that you joined: ___________________________

Referred by: __________________________ Type of Bike: _________________________

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