CLUB MEMBERSHIP FORM
(PLEASE ENSURE YOUR WRITING IS LEGIBLE, UN-READABLE FORMS HAVE TO BE RETURNED)
I/we would like to apply for Membership to the Mendip Model Racing Car Club (MMMRC) for the period ending 31ST DECEMBER 2010.
Personal Information:
Name(s) ………………………………………………..Junior Member D.O.B…………….......
Address…………………………………………………………………………………………...
……………………………………………………………………………………………………
Postcode…………………………… E-Mail address (important) ..................................................
Evening Telephone Number………………………………...........
Scale(s) raced: [ ]1/5th IC. [ ] 1/8th IC. [ ]1/10th Electric. [ ]1/10th IC. [ ]Bikes.
BRCA Number (from last year if applicable) …………………....
Membership Type:
Please tick at least below to identify which membership type you are applying for:
[ ] Family Membership @ £80 (1 Adult plus 1 child)
[ ] Each Additional child with Family Membership @ £23
[ ] Adult Membership @ £65 each
[ ] Junior Membership @ £40 each
[ ] Associate Membership (NON RACER / DRIVER NOT ABLE TO USE TRACK) @ £20 each
[ ] Tick here if you already hold a 2010 BRCA membership, £13 can be deducted from any of the costs above
I enclose a cheque for the sum of £…………… payable to MMMRC.
Membership of the MMMRC is open to all persons. A full years membership runs from the 1st January each year.
Application Confirmation:
I/we have read and agree to abide by the MMMRC club rules and regulations (available from www.mmmrc.org) and the BRCA club Rules and Regulations as in the current handbook.
Signed…………………………….………… Date…………………..
The club holds personal data in respect of its members on a computer. In accordance with the Data Protection Act
1984, the club may use such data for the following purposes:-
a) Disclosures to authorized officers of the club for the purposes of day to day membership administration.
b) Disclosure to the circuit landowner for security purposes.
c) The publication from time to time of a membership list for the exclusive use of Members in pursuance of
their hobby and not for trade purposes.
For further information please contact me below, otherwise forward this completed application form with your cheque and BRCA application form ( Overleaf ) to:
The Membership Secretary (MMMRC)
VAL NAPPER, 96 LISIEUX WAY, TAUNTON, SOMERSET, TA12LF.
01823279365 Valken@sky.com |