2020 Dudley Radio Car Club Membership Form

2020 Dudley Radio Car Club Membership Form
Membership to DRCC is £5.00 and expires 31st December 2020.

Fill in this form, submit it, hand over £5 to the race director, sit back and relax whilst we verify your BRCA licence and prepare your card. Easy!

Once you receive your card you’re now a member!
Members Name *

First Name Last Name
Admin

BRCA verified Card issued Membership Paid
Membership Type *

Adult (16 or over) Junior (under 16)
Date Of Birth *

Day Month Year
Date Picker Icon

Address *

Home / Mobile Number *
Email Address
Do you want to be contacted via email about details on club events / offers? *

Yes No
2020 BRCA Membership Number *
Without a valid BRCA membership you are not permitted to race
Members under 16 require a parent’s / guardian’s consent
Parent / Guardian Of Member *

First Name Last Name
Are the details the same as above? *

Yes No

Address *

Home / Mobile Number (Incase Of Emergency) *
I {parent10} accept full responsibility of {membersName} whilst they take part in any activities of Dudley Radio Car Club
Parent / Guardian Signature

Clear
I {membersName} have read and agree to abide by the following *

Club Rules

Constitution

Privacy Policy

Data Protection Policy

*If you have no access to these documents, please ask for a copy at the club before signing
Signature *

Clear
Should be Empty: