Gwendraeth Valley Motor Club Membership Form 2012
www.gwendraethvalleymotorclub.co.uk
I/We wish to become a member of Gwendraeth Valley Motor Club Ltd.
Name :......................................................................... Memb. No. ....................
Address :............................................................................................................................................................
................................................................................................................... Post Code ..................................
Telephone No. ............................................................. Mobile ...............................................................
e-mail .....................................................................................Do you require club stickers YES NO
I do not hold a valid competition licence issued by any national automobile club (other than a club within the European Union). I declare
that I shall not drive in any part of a competition which take place on the public highway unless I hold a valid motor vehicle driving licence
(other than provisional) and I am acquainted with and agree to be bound by the General Regulations of the MSA.
I/We agree not to take part in any Motor Sport Event not authorised by the MSA.
Signature : ............................................................................... Date :................................
Please enclose membership fee of £7 for Full Membership. Please enclose membership fee of £10 for Married Couples.
Please make cheques payable to Gwendraeth Valley Motor Club Ltd. And send them together with this completed form to
the Membership Secretary.
Kevin Hughes 6 Penllwynrhodyn Road Llwynhendy Llanelli SA14 9NL
Telephone Mobile 07968 555324 e-mail kev@kevhughes.com
I would also like to register for the following Club Championships. Please tick the appropriate box
Road Rally Tarmac Rally Forest Rally Sprint Marshal
Gwendraeth Valley Motor Club Membership Form 2012
www.gwendraethvalleymotorclub.co.uk
I/We wish to become a member of Gwendraeth Valley Motor Club Ltd.
Name :......................................................................... Memb. No. ....................
Address :............................................................................................................................................................
................................................................................................................... Post Code ..................................
Telephone No. ............................................................. Mobile ...............................................................
e-mail .....................................................................................Do you require club stickers YES NO
I do not hold a valid competition licence issued by any national automobile club (other than a club within the European Union). I declare
that I shall not drive in any part of a competition which take place on the public highway unless I hold a valid motor vehicle driving licence
(other than provisional) and I am acquainted with and agree to be bound by the General Regulations of the MSA.
I/We agree not to take part in any Motor Sport Event not authorised by the MSA.
Signature : ............................................................................... Date :................................
Please enclose membership fee of £7 for Full Membership. Please enclose membership fee of £10 for Married Couples.
Please make cheques payable to Gwendraeth Valley Motor Club Ltd. And send them together with this completed form to
the Membership Secretary.
Kevin Hughes 6 Penllwynrhodyn Road Llwynhendy Llanelli SA14 9NL
Telephone Mobile 07968 555324 e-mail kev@kevhughes.com
I would also like to register for the following Club Championships. Please tick the appropriate box
Road Rally Tarmac Rally Forest Rally Sprint Marshal