North Bucks Harness Club

Membership Form

Date

Surname-

First name-

Family members likely to come to meetings-

Address-

Postcode-

Phone Number-

e-mail address-

I confirm that I hold appropriate 3rd party insurance while driving.

Signature-

Please return this form with membership fee of £10

Cheques made out to North Bucks Harness Club to

Alan Pridgeon

Laburnum Lodge

High Street

Ludgershall

Bucks

HP18 9PD

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