Membership Form Oops! Missing FieldsetIf you are seeing this message, it means you need to <strong>add a Fieldset to the beginning of your form</strong>. Your form may not function or display properly without one.Forenames * Title *Surname *Address *Town Postcode *Email *Tel. *Mobile I wish to apply for the following grade of Membership and use of Glencoe Boat Club facilities for 2021 - please tick boxes as appropriate: *Adult Membership £75 - Includes access to clubhouse and stores, (Membership runs from 1st November to 31st October.)Joint Membership £130 - Couple residing at same address.Member’s Kayak/Canoe Storage £20 - Compliant with GBC Mooring PolicyFamily Membership £165 - Adult, partner and children 16 yrs & under, (Membership runs from 1st November to 31st October.)Junior Membership £30 - For members 16yrs of age & under. (Membership runs from 1st November to 31st October.)Student Membership £30 - For member 17yrs and over in full-time education, (Membership runs from 1st November to 31st October.)Mooring fee £200 (If allocated a mooring space) – Membership also requiredClub Mooring fee £300 (Rental of a Club mooring) – Membership also requiredMember’s Boat Storage (Summer) £100 - Compliant with GBC Mooring PolicyMember’s Boat Storage (Winter) £100 - Compliant with GBC Mooring Policy Family & Junior Membership: In the interest of Safety and Security please provide the names of all family members in the space below and for Juniors their age too. I wish to apply for a new/continuing mooring space for the following boat and confirm that as a mooring holder I will agree to the Terms and Conditions of the Club’s Moorings Association.Boat Name Boat Make and Length I confirm that the insurance policy for my boat/s detailed above covers Third Party Liability. Tick (Please note that if you have a boat moored and/or stored on Club premises we require you to have appropriate current insurance cover.) I hereby undertake to contribute such amount as may be required (not exceeding £1) to the company’s assets if it should be wound up whilst I am a Member or within one year after I cease to be a Member. Please tick box to confirm acceptance: *TickI am a UK taxpayer and I give permission for Glencoe Boat Club Ltd to claim gift aid off any donations or subscriptions I make to the Club. *YesNoI prefer to pay by: *BACSCashChequeDirect Debit BACS payment is preferred. Club banking details: Sort Code: 83-20-16 Acc no: 10838145Please note all membership fees are due by the 31st January 2024, Late payment incurs a fee: Single membership £100, Family Membership £175. *TickHTML Visual Code Instructions FieldsetURL URL Address Street AddressApt, Suite, Bldg. 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