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									Send with cheque payable to Bexley Athletic Club for appropriate Subscription
amount to :- Membership Secretary C/O 242 Rydal Drive, Bexleyheath., Kent,
DA7 5DG


 Bexley Athletic Club
                         President: Gill Freeman


         Form of Application for Membership

Surname_____________________________________________________

Forename(s)__________________________________________________

Title Mr/Mrs/Ms/Miss/Master/Other__________

Date of Birth______________________Tel. No.______________________

Address______________________________________________________

_____________________________________________________________

_____________________________________________________________

NATIONALITY_________________________________________________

If previously a member of another club, state club and date of resignation.

PREVIOUS CLUB_____________________DATE RESIGNED___________



Bexley AC is affiliated to Kent County Athletic Association and South of
England Athletic Association. Competition is held under UKA rules.


I HEREBY DECLARE THAT THE ABOVE PARTICULARS ARE CORRECT
AND THAT I WILL ABIDE BY UK ATHLETICS RULES AND REGULATIONS
FOR COMPETITORS.

Signed_____________________            Date_____________________

Parents consent signature___________________________________
(Required for athletes under 15 years)

Date of election____/____/____

President_________________________ Secretary______________

								
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