Lancashire Grass Track Junior Riders Club

2008 Membership

Please Note: One form Per Member .Minors must complete reverse of this form.

Name:
Address:
(Block Capitals)
		Postcode:
Telephone No:
Mobile No:
(Contact number day of meeting)

I wish to become a member of the above named club. I agree to abide by the rules and regulations of the LGTJRC and the ACU. I will also provide a marshal for meetings as required.

Licence No:	Capacity:
Type of Machine:
Date of Birth: Must be completed by all riders.	Riding No: Please choose two numbers.	1^st	2^nd

Classes: please tick box / boxes which apply.

2008 Youth Grass Track Classes: - age on 1^st January 2008

Auto Cadet	6/7 years	250cc	Adult
Cadet	6/7/8/years	350cc	Adult
Junior	9/10/11 years	500cc	Adult
Intermediate	12/13/14 years	Unlimited Novice	Adult
Senior	15/16,17,18 years	Unlimited Moto X	Adult
Moto X 65	7/8/9/10 years	Short Track A	Adult
Moto X 85	9/10/11/12/13/14/15 yrs	Short Track B	Adult
Moto X 125	14,15,16 yrs	Short Track	Youth
Non Rider	Youth / Adult

N.B. All riders in Moto X classes also have to have a Grass Track Licence.

Please tick boxes below, which apply.

	I / My Parent / Guardian sign below to say that I / they agree to my taking part in Motor Cycle Grass Track Racing.
	I enclose membership fee of £10.00 per rider.
	I enclose membership fee of £5.00 per non-rider.

Any member under the age of 18 must complete a consent form on rear of this form.

Riders Signature:____________________Parent/Guardian Signature:_________________

Please complete and return with SAE & fee made payable to LGTJRC to:

Julie Lowe

Liversage House, 83 Underlane, Grotton, Oldham. Lancs OL4 5RN

Membership details may be kept on computer. If you do not wish your details to be kept on computer please tick box.

Please tell us where you heard about us. Please circle one: Existing Member. G mex. Other - please state.

29.12.07