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If you wish to join or renew your Membership please fill out the form, attach payment and post to:

ESCC Membership, PO Box 216, Gore

Name (s) ________________________________________________________
Address ________________________________________________________
________________________________________________________________
________________________________________________________________
Phone __________________________________________________________
E-mail __________________________________________________________

(please fill in your e-mail address as this is how our news is sent out)

Age group (under 18) * (18-25) * ( 26-35) *  (36-60) *  (61+)
(Please circle one )

Single Membership $50-00
Couple Membership $55-00
Junior Membership $25-00

Total $ __________________

(Junior members must be under 18 years old on 1st June 2010 and require an under age
indemnity signed by a parent or guardian to Compete in events.)