Membership Request

Note: Everything marked with a * is a required field.

Personal Details

* Name

First and Last name

* Address

Home address

* Postcode

Telephone Number

Home phone number

Mobile Number

Mobile Phone Number

* E-mail Address

For under 18 year olds, this is their parent/carer

* Date of Birth

Under 18 year olds should have their parent/carer fill in the their email and complete the details on page 2

For existing MYA members, please provide your club name

and your MYA membership number (if you can remember it)

Modelling Interest (Optional) Please provide a list of the yachts or scale models you have

Under 18 years old

Name of Parent/Carer

First and Last name

E-mail of parent/carer

Acknowledgement Enter your name here, by returning this completed form, I agree to my son/daughter/child in my care taking part in the activities of the club. I understand that I will be kept informed of these activities – for example timing and transport details. I understand in the event of injury or illness all reasonable steps will be taken to contact me, and to deal with that injury/illness appropriately.