Membership form 2017-18.xlsx
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Wyre Forest Canoe ClubAffiliated to the British Canoe Union
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Membership Application FormRegistered Charity No. 1111262
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April 2017 – March 2018
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Personal Details
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First NameHome Tel
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SurnameMobile No
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AddressEmail
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Date of Birth
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BCU Member?
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Post Code
Membership No.
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Emergency Contact
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NameRelationship
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Address
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Post CodeContact Tel
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Introductory Sessions
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Session #1DatePaidAs an Affiliated Club, it is a condition
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Session #2DatePaidof our Insurers that anyone taking part
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Session #3DatePaidin club activities is a member after
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Session #4DatePaidtheir 4th session.
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Medical Conditions - Continue on separate sheet if required
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Annual Membership
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I am applying for Annual membership as - please fill an application form for each applying member
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£30Single, Adult£50Two Members
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£15Junior/student£60Family (Household)
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Declaration of Applicant:
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I have read and understand the Terms and Conditions of Membership. I declare that the information provided is accurate to the best of my knowledge. By signing (or entering my name in case of electronic submission) I agree that the information can be stored electronically and reasonable steps will be taken to safeguard my information.
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SignedDate
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Fees and forms to be sent to
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by Post Membership Secretary,c/o 35 Claughton St, Kidderminster, DY11 6PU
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or by Email info.wfcc@googlemail.com
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PaymentsCheques made payable to Wyre forest Canoe Club
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Or by Bank transfer to. -    Sort Code: 40-26-08     Account number: 61760785
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