EAST KENT SCHOOLBOY SCRAMBLE CLUB
Affiliated to the BRITISH SCHOOLBOY MOTORCYCLE ASSOCIATION (BSMA)

APPLICATION FOR ANNUAL MEMBERSHIP 2008

Membership subscriptions are renewable on 1st December each year.   The annual membership fee of £40.00  entitles both parents and all children of each family (or Adult member and immediate family) to the benefits of the Club, including admission to all events held during the year.  Non-riding Members also welcome.
                               
 THE COMMITTEE RESERVES THE RIGHT TO REFUSE ENTRY.
 

 Parent Details (School Person Only)    Adult Rider  
. .
 Name in full  Name in full
 Address    Address  
. .
. .
. .
 Post Code    Post Code  
 Telephone No    Telephone No  
 Occupation    Occupation  
 Relationship to Rider                                          Next of Kin                                            Tel No 
   RIDER #1    RIDER #2  RIDER #3
 Rider's Name . . .
 Address (If different from above)   

.

. .
  . . .
. . . .
. . . .
 Date of Birth   . . .
 Occupation, if over 16   . . .
 Machine Make & cc   . . .
 Class & Rider No.   . . .
 BSMA Licence No.   . . .
 Parent Club for Licence  
 Please state any other Motocross Clubs you hold membership to:  

DECLARATION:      I agree to make my family members and myself conversant with the rules of the EKSSC and the governing body, BSMA.   I understand that it is my responsibility to ensure that these rules are abided by. 
I FURTHERMORE UNDERSTAND THAT I WILL BE REQUIRED TO DO MARSHALLING DUTIES AS AND WHEN REQUESTED, OR TO PROVIDE A RESPONSIBLE ADULT MARSHALL (MUST BE 18 YEARS OF AGE OR OVER).  

SIGNATURE  

PRINT NAME  

DATE

THE SIGNATORY ON THIS FORM WILL BE DEEMED TO BE HEAD OF THE FAMILY 
Please note: incomplete application forms will not be accepted.  The annual membership fee of £40.00 must accompany this application.  Cheques made payable to “East Kent Schoolboy Scramble Club”. 
Postal applications should be sent together with a stamped self addressed envelope to:     
COMPETITION SECRETARY:
                       Mr Gary Lane
                                               
                      PO BOX 272
                                                                     DARTFORD
                                                                     DA1 9BH
                                     VISIT THE WEBSITE AT HYPERLINK  http://www.ekssc.co.uk

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