walesandwestenduroclub

Membership Form

Membership for 2021 NOW open

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NAME *

ADDRESS *

POSTCODE *

E-mail address: *

D.O.B. *

BIKE *

MODEL *

CC *

PREFERRED RIDER NUMBER IN CLASS. EXPERT 1 TO 50 SUPERVETS 51 TO 100 VET 101 TO 150 CLUBMAN 2T 151 TO 200 CLUBMAN 4T 201 TO 250 SPORTSMAN 2T 251 TO 350 SPORTSMAN 4T 351 TO 450 LADIES, T/SHOCK, TRAIL, EVO, 451 TO 600 OVER 50S 600 TO 650 YOUTH 650 TO 7

CLASS :- EXPERT , SUPERVET (over 40) over 50) , VET (over 40), CLUBMAN 4T, CLUBMAN 2T, SPORTSMAN 4T, SPORTSMAN 2T, LADIES , TWINSHOCK, TRAIL, EVO , YOUTH upto 150cc 2T, 250cc 4T, 15-17yr old . *

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Contact details may be passed to Pentagon Insurance who may contact you to offer competitive insurance quotes . tick box if you do not consent to your details being shared

TRANSPONDER NUMBER if applicable

PARENT'S NAME IF UNDER 18

I herby agree that my data entered in the contact form will be stored electronically, and will be processed and used for the purpose of establishing contact. I am aware that I can revoke my consent at any time.

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membership 2021

12.00 GBP

please add to notes rider who you are paying for !!!