Vauxhall Recreation Club - membership information

NON-EMPLOYEE MEMBERSHIP APPLICATION FORM

Completed application forms for Associate only memberships should be returned with payment to Vauxhall Recreation Club, Brache Clubhouse, 20 Gipsy Lane, Luton, Beds. LU1 3JH. Tel: 01582 418860. For Section Associate memberships - application forms need to be authorised by the relevant Section, as shown below. Part 1 must be completed in all cases. Both parts must be completed if a section membership is required.

NAME

ADDRESS

HOME
TEL NO.

MOBILE
TEL NO.

EMAIL:

D.O.B.

SIGNATURE

The appropriate subscription must be paid before a membership card can be issued.

	£38.00 per annum inclusive of VAT for Associate Membership.
	£32.00 per annum inclusive of VAT for Section Associate Membership.
	£19.00 per annum for Senior Citizen Associate Membership (i.e. male over 65, female over 60)
	£16.00 per annum for Junior (U18's) and Senior Citizen Section Associate Membership.

PART 2 APPLICATION FOR SECTION MEMBERSHIP

I wish to join Vauxhall Recreation Club as a Non-Employee member, for the purpose of joining:

SECTION

PASSED BY THE SECTION ON
DATE OF BIRTH IF UNDER 21)
PLEASE STATE IF SENIOR CITIZEN
AT A FEE OF PER ANNUM
CHAIRMAN'S SIGNATURE
SECRETARY'S SIGNATURE
Special note: The club does not accept any responsibility for any accident, however caused, which may occur to Non-Employees as result of their participation in club activities- Without prejudice to the generarity of the foregoing, no liability is accepted for any negligence on the part of any servant or agent of the club.
DATE OF APPLICATION
TAKEN BY
FOR OFFICE USE ONLY
CLUB MEMBERSHIP:
SECTION MEMBERSHIP:
TOTAL INCLUSIVE OF VAT
RECEIVED BY
DATE
RECEIPT NO