Frankley Model Car Club

Club Membership Form 2010

Name......................................................................... BRCA No....................

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

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

Email Address .................................@...............................Tel..................................

Please Circle     Under 19      Under 16     Under 13     Under 40      Over 40

Class     Buggy         Truggy        Both

Xtals ...................... ......................... ....................... .................. 2.4 GHZ..................

PT.............................................

I have read and agree to abide by the Frankley Model Car Club constitution set out quite clearly to protect the Club and its Members, i also agree where practicable that if called upon subject to availability i/we will help with club duties from time to time

Name .......................................                                                                                                                  

Signature .....................................                                                                                            

Date ........................................  

Fee                    Family  £25                            Individual £20       

BRCA Insurance £13                                                                                                                  

Total ..........................................                                                                                               

Form to be sent together with payment to

8,Stourdell Road,Cradley Heath, Halesowen, B63 2AN Please make cheques out to FMCC