I the above named apply for membership of the Northern Counties Off Road Triallers Club. Membership being subject to approval by the Committee. I agree to abide by the rules (copy available on request) and understand that participation in club events is at my own risk. I am aware that NCORTC have developed a Child Protection Policy. Members under 18 years must have written consent from a Parent/Guardian (see the next section below) and be signed on by them at every trial entered.

This document must be read and this section counter signed by the Parent/Guardian of the above named applicant if they are under 18 years of age. I as Parent/Guardian of the above named applicant am aware that NCORTC have developed a Child Protection Policy, a copy of which is attached to the club rules. A Child Protection Officer vetted by the MSA is available and contact details are published by the Club. I also understand that the Club will attempt to keep records of all persons using video and photographic equipment at events. I am aware that it may be possible that images with my child in the picture may be published. I will advise the Official at signing on, in writing, of details of any known allergies, conditions, medication being taken by my child. I also give consent to medical treatment to be administered to my child where considered necessary. In the event that my child should require emergency hospital treatment, and I cannot be contacted, I authorise a qualified medical practitioner to provide emergency treatment and medication. 

The clubs bank details are as follows: Account Name – NCORTC Sort Code – 05-06-81 Account Number - 33578674 Please send payment through after you have filed in this form. Payment and forms will be matched up by the membership secretary and your membership details will be sent out to you.