2024 Membership Form

I hereby make application to join the Fermanagh Motorcycle Club Ltd and agree to abide by the rules of the club.

I would like to take out annual membership as indicated below:

ANNUAL RENEWAL DATE 1ST October

I would like to take out annual membership as indicated below:

ANNUAL RENEWAL DATE 1ST October FULL MEMBERSHIP £10.00 (Please complete sections A & C) JUNIOR MEMBERSHIP £5.00 (Please complete sections A & C) FAMILY MEMBERSHIP £20.00 (Please complete ALL sections)
SECTION A

Details of the Applicant
Name Name First Last
Address Address
Street Address Address Line 2 City County Postcode Country
Mobile Phone
Email
AGE

AGE 0 - 17 yrs 18 - 24 yrs 25 - 44 yrs 45 - 64 yrs 65 yrs +
SECTION B

Details of other Family Members
Family Member 1's Name Family Member 1's Name First Last
Family Member 1's Age

Family Member 1's Age 0 - 17 yrs 18 - 24 yrs 25 - 44 yrs 45 - 64 yrs 65 yrs +
Family Member 2's Name Family Member 2's Name First Last
Family Member 2's Age

Family Member 2's Age 0 - 17 yrs 18 - 24 yrs 25 - 44 yrs 45 - 64 yrs 65 yrs +
Family Member 3's Name Family Member 3's Name First Last
Family Member 3's Age

Family Member 3's Age 0 - 17 yrs 18 - 24 yrs 25 - 44 yrs 45 - 64 yrs 65 yrs +
Family Member 4's Name Family Member 4's Name First Last
Family Member 4's Age

Family Member 4's Age 0 - 17 yrs 18 - 24 yrs 25 - 44 yrs 45 - 64 yrs 65 yrs +
SECTION C
Membership Type

Membership Type NEW RENEWAL
Do you require a MRA Licence Form to be sent to you?

Do you require a MRA Licence Form to be sent to you? YES
Please specify if Adult or Youth Licence Form is required

Please specify if Adult or Youth Licence Form is required ADULT YOUTH
Signature of Applicant

Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date Date / DD / MM YYYY
Applications for membership to the Junior Section must be also signed by a parent/guardian if the applicant is under 18

SIGNATURE OF PARENT/GUARDIAN

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Notes to the Application.

1. The principal name on this application shall be treated as a full club member (age permitting) as per rules of the club.

2. Other family members named in section B shall be deemed as social members.

3. Applications for membership to the Junior Section must be also signed by a parent/guardian if the applicant is under 18.

4. Any information given on this form shall be for club use only and will not be shared with any third parties.

2024 Membership Form

2024 Membership Form

SECTION A

Details of the Applicant

SECTION B

Details of other Family Members

SECTION C

2024 Membership Form

2024 Membership Form

SECTION A Details of the Applicant

SECTION B Details of other Family Members

SECTION C

SECTION A

Details of the Applicant

SECTION B

Details of other Family Members