Membership Form Membership Application / Renewal Form I wish to pay by: BACS / Standing Order Paypal Name* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Address* Street Address Address Line 2 City Postcode Home PhoneMobileEmail*Please provide an e-mail address ICE PhonePlease give an Emergency Contact Name and the Phone Number it is best to contact them on.ICE Name ICE RelationshipHusbandWifePartnerFatherMotherQualified First Aid Yes Notes* “I hereby apply to be admitted as an Annual Member of the Harewood Combined Training Group and agree to be bound by its rules” Permissions*Harewood Combined Training Group will use the information you provide on this form to be in touch with you and to provide updates and marketing. Please let us know all the ways you would like to hear from us: The information given above will be held on a database by the Membership Secretary and BRC Head Office and is used for administrative purposes only. NO INFORMATION WILL BE PASSED BY HCTG TO 3RD PARTIES. We use Mailchimp as our marketing platform. By submitting this form you acknowledge that the information will be passed to Mailchimp for storage. You can change your mind at any time by clicking the unsubscribe link in the footer of any email you receive from us, or by contacting us at andrew.askeane@gmail.com. We will treat your information with respect. For more information about our privacy practices please visit our website. By clicking below, you agree that we may process your information in accordance with these terms. Select All email Phone Text Post Image Usage Date* DD slash MM slash YYYY MembershipThe Club Year runs from 1st January to the 31st December Online payment includes a £1.50 booking fee to cover our Paypal administration charges. Price:
