Please Print Form below, Fill in and Return to the given address



Membership Application/Renewal

Name______________________________________________________
Address___________________________________________________
________________________________________
________________________________________
Postcode_________________________ Tel:- _____________________
E-Mail:-___________________________________________________

TYPE OF MEMBERSHIP
Please Tick

Full£20__________Family£20__________
Non Driving£13__________Junior£10.50__________

Third Party Liability:-
Driving applicants will be asked to provide proof of current Third Party Liability Insurance at the start of any of the Club Events.

If applying for Full, Family or Junior Membership please name the drivers and state whether they have successfully completed the BHDTA Drivers Assessment with The Shepway Harness Club or another Club.

DriverAssessed
Yes/No		Club Which
Assessed		Date of
Assessment		Date of Birth
(if under 18)
        _             
____

                                                                                                         Please tick

Cheque enclosed   £__________    Badge £3-00   _________

Please Make cheques payable to:-  SHEPWAY HARNESS CLUB


Signed   _______________        Date  __________

Please return Form and Cheque to:- The Membership Secretary,
Jon Studd, Hunger Down, Arpinge, Folkestone Kent CT18 8BQ
                                 (Tel :- 01303 273477)