Membership form

                   Be a part of the official disabled fan group

                      Annual Membership 5 per person
                      Family Membership 10  (2 adults & 2 children)























For more details contact
Secretary Keeley Longdon 07850 428650 or @keeley32@btopenworld.com
Chairman Chris White         01142 465547 or @ wharfedalewhite@aol.com

Please Return postal completed forms to
57 Goodwin Road
Rockingham
Rotherham
S61 4DF












Name
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annual
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