Liverpool Land Rover Owners Club Membership Form
Please fill in all relevant details then click submit at bottom of page                 

Title First Name Surname 
Address 1 
Address 2 
Address 3 
Post Code 
Telephone Number
Mobile Number     
E-Mail Address     

Would you like to be kept informed about club news / events by E-Mail, please tick the box.

Tick this box if you do not wish to be contacted by other club members.

Type and colour Of Vehicle 

Vehicle Registration Number

Data Protection Declaration
In accordance with the provisions of the Data Protection Act 1998 any personal data which is supplied to Liverpool Land Rover Owners Club will be held in a secure database and will be used solely for the purposes of Liverpool Land Rover Owners Club. These details will not be passed on to any other organisation.
Disclaimer
I accept and understand that if I choose to participate in any activities or events organised by Liverpool Land Rover Owners Club I will do so at my own free will and will not hold Liverpool Land Rover Owners Club or its representatives and elected officials responsible for any damage that might occur to my vehicle or any injury I may sustain however caused.
 
The committee reserves the right to revoke any membership, without refund, of any member bringing the club into disrepute.
 
I agree to be bound by the rules and constitution of Liverpool Land Rover Owners Club, and it's affiliated organisations.

Signed (please re-type name)
Date

Please send a £15 crossed cheque or postal order made payable to
"Liverpool Land Rover Owners Club" to:
LLROC Membership, 1 Rawcliffe Road, Walton, Liverpool, L9 1AN, United Kingdom