Shopping bag

Shopping bag

Email address*

Member Surname*

Member First Name*

Member Forum Name

Joint Surname

Joint First Name

Joint Forum Name

Address*

Rocket Model*

Reg Number

Colour

Type

Solo

Trike

Combo

I/We certify that the above details are correct, and authorise the club and other members to contact me from time to time with regards to club business and/or activity using the information provided on this form*

By submitting this form you agree to the above statement

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