Name

 

Address

 

 

Postcode

 

 

Telephone

 

 

Email

 

 

Birth Date

      

Which of the events listed below interest you?

(Please check all that apply)

 

Trials

Social

Enduro

   

Are you currently a member?

New application       Renewal  

Do you object to the Double Five holding your membership record on computer?

No       Yes  

 

Youth Membership (under 16) - Free of charge!

Youth Membership (ages 16 - 18 inclusive) or

Adult Membership (under 60) - £15.00 per year (Nov to Oct) or £10.00 if applying after April 30th.

Adult Membership (60 and over) - Free of charge!

 

Please note, all membership fees exclude competitors £10 ACU registration fee, which is payable directly to the ACU.

 

You must press Submit to send your form, or Reset to start again.