1999 COBRA Membership Application


Mail to:  COBRA
          3501 Truman Ave.
          Bakersfield, CA 93309        Email COBRAps@aol.com

NO APPLICATIONS WILL BE ACCEPTED WITHOUT PAYMENT.

MEMBER INFORMATION - PLEASE PRINT

  Check one:

___ New member;

___ Renewing; please give COBRA number ____________________

Name: Last ___________________First _________________ Birth Date(mm/dd/yr)_______________

Racing Age (as of 12/31/99):_______________

E-Mail Address _____________________________________________

Mailing Address ____________________________________________

City ___________________________  State ______  Zip ___________

Day Phone (_____) _______________   Eve. Phone (_____) _______________  

Sex: Male ___ Female ___  Race Team or Club, _______________________________

NORBA Number, if any _________________________

NORBA Rider Categories
                              Cross
                             Country  Downhill
Beginner                       ____     ____
Sport                          ____     ____
Expert                         ____     ____
Semi-Pro / Pro                 ____     ____

 Signature _____________________________________________________

ANNUAL MEMBERSHIP FEES

COBRA Membership (Paid once per year):   $5.00
    Fee is for the current 1999 race season (3/13/99 - 12/31/99) only.

COBRA Rules

COBRA will award Jerseys to the top 3 winners of each Class/Category in December 1999. 
Only those classes containing appropriate number of members will qualify.

If you move up a Class you will still accumulate points in your original class.