THE LITTLE MIDLAND SOCIETY, CHESTERFIELD
MEMBERSHIP APPLICATION
Name(Please print)…………………………………………………………………………………………………..
Address………………………………………………………………………………………………..
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Postcode………………………………….
Date of birth if under 18………………………………………………………….
Please note members under the age of 16 MUST be accompanied at all times by a responsible adult.
I enclose a cheque payable to “The Little Midland Society” for £……………….
Please see current rates for the amount
Email address…………………………………………………………………………………………..
I have read the Society’s rules and agree to abide by them.
Signed………………………………………………………….Date……………………………….