Junior Membership Renewal/ Joining Form

Name *
Name
Date of Birth *
Date of Birth
Address *
Address
Parent or Guardian
Parent or Guardian
Type of Membership *
Ham Polo Club Sort Code 16-00-28 Account Number 00157857 SELECT MEMBERSHIP TYPE BELOW PAYMENT IS REQUIRED WITHIN 24 HOURS OR FORM WILL REQUIRE RE-SUBMISSION. IF YOU ARE APPLYING FOR NEW MEMBERSHIP, APPROVAL IS REQUIRED, PLEASE CONTACT THE OFFICE PRIOR TO PAYMENT.
General Release & Waiver of Liability *
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