GRASA

2017 Membership/Renewal

Name……………………………….......

Address………………………………....

………………………………................

………………………………................

Postcode…………….Phone No……….

E mail…please tick to receive newsletter by e mail (    )

………………………………..................

ACU Affiliation No……………………..

Supporter /Official £8.…………………..

Husband/Wife (supporter)£12.………….

Rider £20.………………..........

Family(with rider) £25.………………..
Family membership us for all NON riding children

Youth £7.50 must have adult as full member………..

Please return completed form with correct fee and SAE to:-
Mrs. D Wain
104 Purbrook Way,
Leigh Park,
Havant.
HANTS
PO9 3SB

Tel: 02392-644061

(Family membership includes all NON riding children under the age of 16 )



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