Lytham St. Anne's Road Runners Club

Membership Renewal Form 2010



First Name(s):

Title:

Surname:

Gender: Male/Female

Address:

Date of Birth:


Home:


Mobile:

Postcode:

Email:


Membership: 1st January 2010 – 31st December 2010

Please tick whichever is applicable.

Cheque payable to: Lytham St Annes Road Running Club

To be returned to: Melanie Koth, Membership Secretary

18 Alexandra Rd, Walton- Le-Dale

Preston PR5 4QS

or: hand it in to me at club meetings

First Claim £23.00


Second Claim £17.00


Juniors ( 11+ - U20 ) £7:50


Juniors ( U8 – U11)
£5:00



Social Member




Please note:

All Membership Fee must be paid by 31st of March 2010, otherwise your membership will cease and you will not be allowed to represent the club in competitions.


Please contact me if any problems.