GEST TRIALS CLUB

MEMBERSHIP APPLICATION FORM - 2009

Acknowledgement of the risks of motorsport: I / we understand that by taking part in these events I / we are exposed to a risk of death, becoming permanently disabled or suffering some other serious injury and I / we acknowledge that even in the event that negligence on the part of the ACU, the promoter, the organising club, the venue owner, or any individual carrying out duties on their behalf were to be a contributory cause of any serious injury I / we may suffer, the dominant cause of any serious injury will always be my / our voluntary decision to take part in a high risk activity. I / we have read the above and acknowledge that my / our participation in motorsport is entirely at my / our own risk and my/our signature on this form is confirmation of this acknowledgment.
THE COMMITTEEE RESERVE THE RIGHT TO REFUSE MEMBERSHIP
ANNUAL MEMBERSHIP COSTS: (please tick the membership applied for)
Adult	£15.00		Youth (under 18)			£9.00		Family		£25.00
Non-riding	£3.00		Associate			£1.00
NB: Family covers all those living at the same address, only 1 newsletter will be sent Non-riding is for those who wish to stay involved with the club and receive newsletters but don’t actually ride Associate is for a parent/guardian of a Youth rider if they are not a riding member themselves, no additional newsletter will be sent. Youth riders must be accompanied by a full or associate member at all events.
Name	Riding Group	Date of Birth (if under 18)		Signature			ACU licence number	Preferred riding number	Parent signature if under 18 (must be a member or associate themselves)
Address:
Telephone no:					Email address:

Please make cheques payable to GEST TRIALS CLUB, any enquiries please ring Julie Blackford on 01580 715858. Please print clearly and make sure you give your ‘phone number and post code – thanks.

Forms should be handed in at signing on or sent to:

Julie Blackford, 6 Angley Walk, Cranbrook, Kent TN17 2HJ