Application for E-Bike Membership

Forenames

Family Name

Date of Birth

Email Address

Address and Post Code

Home Phone Number

Work Phone Number

Mobile Phone Number

Are you fit to cycle? Describe any medical conditions that might affect your cycling ability:

I have read and understood the Moray Carshare Membership Agreement, Tariffs and Privacy Statement highlighted below. I agree to abide by these rules & agreements. I give my permission for Moray Carshare to enter the details given here onto an electronic database for use by Moray Carshare only. I have read and understood the Moray Carshare Membership Agreement, Tariffs and Privacy Statement highlighted below. I agree to abide by these rules & agreements. I give my permission for Moray Carshare to enter the details given here onto an electronic database for use by Moray Carshare only. I agree