<p> The Cornwall Reptile and Amphibian Group (CRAG)</p><p>If you wish to remain / become a full member of CRAG please complete and return this form electronically to the CRAG Membership Secretary. [email protected] </p><p>In order to comply with insurance requirements we must maintain an up to date list of all members. The following information ensures that we can demonstrate we are doing so. Please note; all members are required to notify the Membership Secretary if their details change.</p><p>Full Name Address Main Contact Mobile: Number Home: (Only one number Office: is required). Email Address For insurance purposes we need to know if you are over the age of 70. Please provide your date of birth (dd/mm/yy) here. ______Do you agree to your contact details being made available to other group members? This would only be done to facilitate direct communication between individuals. YES I agree to the above NO I do not agree to the above</p><p>Signed Signed</p><p>Annual membership is £5 (renewed at the AGM) but is free to full-time students – payment can be made by cheque or BACS. Please send cheques (made payable to CRAG) to the Treasurer: Mark Nicholson, Barn Wyn, Marazanvose, Truro TR4 9DQ. </p><p>Alternatively payment can be made by BACS: Bank:HSBC Sort Code:40-27-04 Account No: 71290339 (Please use your last name and initials as the payment reference)</p><p>Please tick if you are a student (please email a scan of your student card to the Membership Secretary or provide your university email address as evidence).</p><p>If it is considered that the activity of a member or applicant is detrimental to the aims or reput ation of the Group, the Management Committee may refuse an application or terminate or su spend the membership of a member by resolution passed at a meeting of the Committee. By joining CRAG you are agreeing to uphold the aims and objectives of CRAG and never to act in any way that could be prejudicial or detrimental to the group. </p><p>Page 1 of 1</p>