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Registration Form for BCGBA Membership
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membershipmanager@bcgba.org.uk
Ref: NMMMAF2.1 – September 2025
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County Association:CUMBRIA
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Club Name:AllithwaiteClub Membership Number:CUM10303CL
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Number ^Mr/ Mrs/Miss /MsFirst NameName 2 Surname Gender M/FDate of Birth (DD/MM/YYYY)
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^ Applications for a Replacement Card only
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Please give reason for requesting a replacement card (eg card lost, card damaged, change of name):
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AddressPost CodeEmailTel: LandlineTel: Mobile
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Self Disclosure:
Is there any reason that approving your membership could negatively impact on the club?
Yes / No
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Have you ever had any Club membership refused or withdrawn in the past?
Yes / No
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Ethnic Origin *Disability or Serious Illness #
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* This is required to show that the sport welcomes all ethnicities
# This is to assist the sport in supporting members with any individual needs
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- it would be appreciated if you could complete the above box
- if no assistance is required please leave the above box blank
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Card to be returned to:
ApplicantPlease tick your
For Office Use Only
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Club Secretarypreferred option
New Membership No. Issued:
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- If you have selected Club Secretary then please give their name and full address below
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Membership Costs are - £20 for a new player - Free for a new player under 18 years of age - £5 for a replacement card
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- please indicate method of payment below:
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 I have paid by bank transfer to the bank details given below the sum of £____ on the following date _________________
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 I enclose a cheque/cash to the value of £ ___________
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Cheque to be made payable to: Cumbria County Crown Green Bowling Association Bank transfer payments to: 01 03 46 29575281
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Send to County Membership Co-ordinator: Mr.Colin Haworth
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Address: 11 Wray Crescent. Kendal. Cumbria. LA9 7NX
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Phone: 01539 732846E-mail: c.haworth21up@gmail.com
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Data Consent: The information given on this membership registration form will only be used in connection with your BCGBA Membership and will not be shared with any other organisation.
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Signature:____________________________________________________Date: _________________________
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