ROLVENDEN ROCKET MEMBER REGISTRATION FORM

ROLVENDEN ROCKET MEMBER REGISTRATION FORM

please fill in the boxes below to register as a member with the Rolvenden Rocket Pilot Wellbeing Scheme run by Rolvenden Parish Council. Once accepted you can book the Rocket Minibus using you unique Reference number supplied below
Date of Application*

DayMonthYear
Member Registration Name*
Name of group or individual
Phone Number*

Area CodePhone Number
Mobile Number*

Area CodePhone Number
Applicants Name*

First NameLast Name
Email
example; rolvendenrocket@gmail.com
Address*

Street Address

Street Address Line 2

Village/TownCounty

Postcode
Invoice Address (If different from above)

Street Address

Street Address Line 2

Town/ VillageCounty

Postal Code
Main Passenger Usage Status*
ie:adults ,children elderly etc:
Minibus driver requirements

Our Group will supply a driver for trainingWe will use a Driver supplied by The Hosts RPCOther

Membership Payment Form*

Annual Subscription Charge £10 automatically renewed£10.00

above amount will be automatically renewed 1 year from payment date unless cancelled by member.

Total £0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

DECLARATION

As official representative of the above Group I apply to register its members to use the RPC Minibus. By submitting this application form, Myself, and our group agree to abide by the Terms and Conditions of The Rolvenden Rocket Not for profit Minibus pilot Project.

I understand that any breach of the terms and Conditions will result in my Group membership being terminated.

Hire Charges.

an Annual Registration Fee of £10 PLEASE PAY THIS today BELOW

The annual registration fee will be automatically renewed unless you request its cancellation.

A Booking fee per trip of £5.00 payable with your your booking.

A Standard Mileage charge of £1.70 per mile for all miles travelled from and return to Rolvenden Village Hall TN174ND.

Using a driver from the Hosts Driver bank will incur addition charges as laid down in our terms and conditions here.

Payment Terms: Booking Fee and minimum 30% deposit to be paid in advance at time of booking .with the balance required within 3 days after your trip .We can also accept invoice payment by BACS using Sort code 60-83-01 account number 20390062 or Cheque (subject to clearance) for security reasons we do not accept cash payments

If paying by BACS please ensure that you add a reference of your trip and your name.
Driver Qualification notes:

It is in a Groups interest to supply their own driver as this will eliminate additional charges being applied

We realise that for certain groups this will not be possible and we a have a qualified group of trained drivers who are always available to take on this role.Dependant on these groups eligibility and at the sole discretion of the management the additional charges may be reduced or waived.

Your Groups Driver will require a CRB Check, A Blue lamp Driver accreditation course and will be required to complete a driver Application form. before being allowed to drive.Please see Terms and Conditions for full details and view the RoSPA Drivers handbook
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