2007 Membership Application
Please sign me up as a card carry'n member of WVMBA!!!

Name: ___________________________________________________________

Address: _________________________________________________________

City/State: ________________________________________________________

Zip: ______________ Phone #: _______________________________________

e-mail: ___________________________________________________________

Male  / Female  (circle one)

Date of Birth: _______/_______/________
(where applicable: based on age as of 12/31/07)

Select a Race Class from the Following List:
All age classifications are based on racers age on Dec. 31, 2007

FEMALE CLASSES:
___ Beginner
___ High School (15-18)
___ Sport
___ Vet (35+)
___ Pro/Expert
    MALE CLASSES:
___ Beginner
___ Junior (14-Under)
___ High School (15-18)
___ Sport (19-34)
___ Sport Vet (35+)
___ Sport Masters (45+)
___ Pro/Expert Open
___ Expert Junior (18-Under)
___ Expert Vet (35+)
___ Expert Masters (45+)
___ Clydesdale (200lbs+)
___ Single Speed Open

Select a Membership Option:
___ $20 Junior-class Annual Member ___ $25 Regular Annual Member
___ $60 Family (Husband, Wife & Children)   ___ $120 Business Member

Make check payable to WVMBA and mail this application form to:
WVMBA / P.O. Box 4292 / Parkersburg, WV  26104