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 9740
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
2011 and require an under age
indemnity signed by a parent or guardian to Compete in
events.)