Severn Road Club

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ApplicationForm

I wish to become a first claim member of the Severn Road Club. I agree to abide by the rules of the club, and accept that the information submitted on this form may be stored in a computer database.

Name:


Address:


Postcode:


Telephone:


Date of Birth:


Email:


Please indicate if you would like to receive electronic copies of the club newsletter:

Member of:

(Either CTC or BC)

Fee paid:

 See the table below.

(If CTC, membership no. & expiry date) 

Signed: .........................................................        Date:

Signature of parent/guardian (if under 18 yrs of age): ................................................................


Complete, print and sign the form and send to:

Steve Hocter, 291 Ormonds Close, Bradley Stoke, South Gloucestershire BS32 0DW. Tel: 01454 616565

 Please make cheques payable to: Severn Road Club

Membership fees:   Rejoining New members
Juvenile (under 16) Free Free
Junior (16-18) Free Free
Senior £10.00 £13.00
Family* £15.00 £15.00

                            Family membership for multiple SRC members per household (one fee for all).
                            A form should be completed by all family members.

           

                            New members receive a copy of the 75th anniversary handbook detailing SRC's history.