Black Mountains Gliding Club

BLACK MOUNTAINS GLIDING CLUB FULL & COUNTRY MEMBERSHIP FORM Membership year starting 1st March 20

PLEASE COMPLETE FORM USING BLOCK CAPITALS ACCOUNT CODE if known

Your Details Next of Kin Details Name: Name: D of B: Contact No(s): Tel No(s): Relationship: E-Mail: Address: (if different) Address:

Flying Details:

Flying in last Total Launches Hours X-C km Launches Hours 12 months: Flying:

Flying Pre Solo Solo BI Ass Cat Full Cat Experience:

Badges held: Official Observer number: (if relevant)

Membership: Joint members please complete a form each with payment details on just one. Associate members please complete Associate’s form.

Full Membership Joint Full Life £

Country Membership Joint Country Home Club: £

Student Membership (under 18 or under 25 and in full time education) £

Associate Membership Associate member name: £

Glider Trailer Parking Glider ID(s): £

Total Amount Due £

I do not suffer from any medical condition that might cause difficulty whilst flying. My current medical declaration is held by BMGC OR I attach my current medical declaration

I understand that I am unable to fly P1 in a club glider unless the club holds a copy of my current medical declaration. I apply to join/renew my membership and declare that I will abide by the club rules & codes of practice as published. I will also comply with the Child Protection Policy as displayed in the clubhouse.

Signed: Date:

Please return to the Membership Secretary, Black Mountains Gliding Club, The Airfield, Talgarth, Brecon. LD3 0EJ

Black Mountains Gliding Club is a company limited by guarantee, registered in England and Wales. Registered number 03194847 Registered office: The Airfield, Talgarth, Brecon, LD3 0EJ