Membership Application and Renewal Form 2027

PLEASE COMPLETE ALL SECTIONS OF THE FORM

Title

First name

Preferred First Name

Last name

Phone

Street Address

Village or Town

Post Code

Date of Birth

Day

Month

Year

Emergency Contact Details

This must be someone other than your partner if they are also a club member

Emergency Contact Name

Emergency Contact Phone Number

Emergency Contact Relationship

The 50+ Adventure Club will use this information supplied by you in this form to process and manage your membership of the Club. The Club also keeps a record of the activities in which you participate. Your personal data may be disclosed to members of the committee. The club will not pass your personal data to any third aprty without your permission.

If you are joining the club we'd like to know how you heard of us.

New membership applications received after 30th September are valid until 31st December of the following year. Please indicate requirement

Please indicate requirement

New membership with email newsletter - £15.00

Membership renewal with email newsletter - £15.00

Please choose your payment method. You will receive your membership pack on receipt of payment

I am paying by bank transfer to Sort Code 40 39 15 Account 11368362 50+ Adventure Club

I am paying by cheque to 50+ Adventure Club sent to Mrs P Ashby 45 Clarence Road Kettering NN16 8PF