Full Name:

Address:

Post Code:

Call Sign:

Telephone:

Email:

Family membership  (family membership rates applies)

Spouse:

Child 1:

Child 2:

Child 3:

Child 4:

Emergency Contact Details:

A person to contact in case an incident occurs whilst you are taking part in club activities. This is in accordance with our policy of “duty of care” to members.

Name:

Relationship:

Phone:

Mobile:

I agree that I and any of my guests or family members shall abide by the rules, standing orders and the Constitution of the Hucknall Rolls-Royce Amateur Radio Club (HRRARC).

I further agree, that any behaviour deemed by a special meeting of the committee, as contrary to the good name and reputation of Hucknall Rolls-Royce Amateur Radio Club may result in my expulsion from HRRARC and foreiture of any membership fees.

By Entering your name and date here, you are agreeing to the statement above.

Name:

Date:

Payment Method: