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     Lincolnshire Kart Racing Club Ltd
          R.A.C. REGISTERED - AFFILIATED TO A.B.K.C.  
       Membership Application 2008
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Membership of the Club entitles you to the following :- Use of the circuit on test days at a reduced rate. 
Discount on race entry fees.  Automatic registration for the Club Championship.
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FOR UP TO DATE INFORMATION PLEASE VISIT OUR WEBSITE  http://www.lkrc.uk.com

Name

  

Class

  

Address

 

 

 

Age
 (if under 17)

  
Transponder
Number 		 

Email Address

  

Post Code

  

Telephone Number

  
Racing
Number

           
Choice One _______________ Choice Two ______________ Choice Three ____________

N.B. Racing Numbers will be allocated on a First Come First Served Basis

I hereby apply to become a member of the Lincolnshire Kart Racing Club (LKRC) and agree to abide by the club rules and regulations.
I understand that membership details are held on computer files, and that such information will be subject to the Data Protection Act.

DRIVER'S SIGNATURE __________________ COUNTER SIGNATURE ________________
                                                                                                (if Driver is under 18)  

MEMBERSHIPS ARE RENEWABLE ON 1ST JANUARY EACH YEAR SUBSCRIPTION CHARGES -
RACING MEMBERS £35 - ASSOCIATE MEMBERS £5

PLEASE COMPLETE THIS APPLICATION FORM AND RETURN TO :-

ROB CANNELL
LKRC MEMBERSHIP SECRETARY
10 MALPAS ROAD
MATLOCK
DERBYSHIRE
DE4 3HT

PLEASE ENCLOSE A STAMPED SELF-ADDRESSED ENVELOPE, WITH YOUR APPLICATION,
FOR RETURN OF CLUB MEMBERSHIP CARD

PLEASE MAKE ALL CHEQUES PAYABLE TO:-L.K.R.C. LIMITED

YOU MUST BE IN POSSESSION OF A CLUB MEMBERSHIP CARD & A RACMSA COMPETITION
LICENCE IN ORDER TO TAKE PART IN A RACE MEETING.

DATE PROCESSED

  

MEMBERSHIP NUMBER ALLOCATED