Couples Membership – Leeds Cycling Campaign Membership

Couple Membership

New/Renew Membership

Two waged adults at the same address can join at the same time by making a single payment of £16.

Annual Membership (Couple) *

Couples – £ 16.00

Donation

If you would like to make an optional donation, please enter an amount below.

Total Amount

Email Address *

Tell us about the other person this membership covers.

Shared Member Details

Name of Second Member

Payment Options

[x] Instructions on how to pay will follow with your confirmation message.

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

County *

Postal Code *