SURFSCAST WALES

Club Membership 2009

One year's club membership for 2009 is just £10. Please fill out the application form below and
hand it to Nigel Hutchinson at the monthly venue.

Surfcast Wales Membership Application

Full Name..............................................................................................................................................

Address................................................................................................................................................

............................................................................................................................................................

............................................................................................................................................................

Post Code..........................................................

DOB..................................................................

Nationality ........................................................

Telephone Home....................................................................................................................................

Telephone Mobile...................................................................................................................................


E-Mail address.......................................................................................................................................



Next Of Kin ............................................................

Medical conditions .................................................................................................................................

............................................................................................................................................................



Print Page

Please print page and hand it to Nigel at the venue together with membership fee

On Line Payments will be available in 2009