Please Complete in Block Capitals and Return to Club Secretary

BYS VYKEN RACE TEAM 2017-2019

ALL SECOND CLAIM MEMBERSHIPS ONLY @ £12.00 EACH Membership will run from April 01 – March 31 2019 PLEASE COMPLETE IN BLOCK CAPITALS AND RETURN TO CLUB SECRETARY @ BYS VYKEN EVENTS & CORNISH TRAILS, 18 HAYLE TERRACE, HAYLE, CORNWALL, TR27 4BT Alternatively email completed membership forms to [email protected] and pay your fee by BACS to the secretary of club bank account S/c 30-13-88 A/c No 18080960 LLOYDS BANK

First Name(s) Last Name Date of Birth

Address

Postcode

1ST CLAIM CLUB IF APPLICABLE:

Telephone Number (including STD code) E-mail address (used to send out club newsletters and event entry forms etc)

Date (of application to join BVRT) If you wish to purchase club kit then this can be done through David Andrewartha, email: [email protected] A price guide is given below: CLUB VEST (£26) BUFFS (£8) CLUB TEES (£30) (CAN BE PURCHASED FROM BYSVYKENEVENTS.VPWEB.CO.UK)

I certify that the information given above is correct. I have read the guidelines for BVRT. I declare that I am an amateur as defined by the ARC rules and that I will abide by these rules. I am medically fit and understand that I participate/enter in any club activities/events entirely at my own risk. I agree that BYS VYKEN EVENTS & CORNISH TRAILS or BYS VYKEN RACE TEAM shall not be liable for any accidents, injury, loss, damage or claim or expense that may arise in consequence of my participation in club activities/events

SIGNED (if hand written) ______

Data will be maintained in accordance with the Data Protection Act and will only be used for internal purposes. It will not be disclosed to third parties. CHAIR : (DAVID ANDREWARTHA) VICE-CHAIR : (GEM FLETCHER) SECRETARY : (DAVID ANDREWARTHA) TREASURERS : (BARRIE PROWSE) CLUB KIT ONLY EXCLUDING BUFFS / (DAVID ANDREWARTHA )EVERYTHING ELSE INCLUDING MEMBERSHIP ROAD RUNNING SECRETARY : (GEM FLETCHER) TRAIL RUNNING SECRETARY : ( TIM TRESEDER) MEDIA & WEBSITE : (DAVID ANDREWARTHA) PRESS OFFICER : (DAVID ANDREWARTHA) WELFARE OFFICER : (SALLYGALSWORTHY-ANDREWARTHA) OTHER COMMITTEE MEMBERS : (ANNA PASCOE ; SIMON JONES ; JACKIE MORSE ;ALAN GILES) CAPTAIN : KIERAN MURRANT OCR CAPTAIN : BARRIE PROWSE