North Iowa Touring Club Membership Application

P.O. Box 1281

Mason City, Iowa 50402

North Iowa Touring Club

North Iowa Spin Mason City Multisports

Name: _______________________________ Address _________________________________

City: ___________________________ State ____________________ Zip Code _____________
Email: _______________________________________ (This should be an email you check frequently)
Home Phone: ___________________________ Office Phone: ___________________________
Cell Phone: _________________________ Emergency contact: __________________________
Parent/Spouse/Significant Other: ______________________________
Age in 2010 (Race Age): ____________________ Date of Birth: _________________________
Road/Cross/MTB Cat: ___________ Licensing Authority: __________ License No. _________
Running Category: _____________ Licensing Authority: ___________License No. _________
Triathlon Category: _____________ Licensing Authority: ___________ License No. _________

Circle areas of Interest:

Cross Country Skiing * Downhill Skiing * Canoeing * Cycling (all genres) * Walking* Swimming
Running * Teach others * Help Organize * Hiking * Camping * Sailing* Snow Shoeing

North Iowa Touring Club1

Single or $15.00
By signing this Family $20.00
membership application, North Iowa Spin/MC22 $15.00
Optional you
you acknowledge (single or family)
understand that training,
Total
participating and
competing in all sporting events are potentially dangerous activities. You agree to hold the
North Iowa Touring Club, North Iowa Spin, and Mason City Multisports, their members,
officers, sponsors, and all other persons and organizations associated with North Iowa Touring
Club, North Iowa Spin, and Mason City Multisports harmless should you be injured or killed.
Further, by signing this contract you agree to bind yourself, your heirs and all personal
representatives. The time period of this contract shall commence on the date signed through
December 31, 2008.

Signature: _______________________________________ Date: ________________________

Printed Name: ________________________________________
Signature of Junior Rider’s Parent/Guardian: _________________________ Date: __________.

[1] NITC membership runs from January 1 – December 31. For new NITC members this membership will include
remaining 2009 and 2010 memberships.

[2] All members of NISPIN and Mason City Multisports must be members of the North Iowa Touring Club.