Because life is for living, not watching

Term & Conditions

Action Scene Membership Application Form

Please complete the form and select method of payment. If you wish to pay by card you will be directed to our secure server to enter your card details.

Note: fields with * are mandatory

Type of Membership: (please select)

Number of members: (for group only)

Primary Member (this must be the name and address of the Card holder named below if paying by card)
Title:
First Name*:		Last Name*:
Address1:		Address2:
Town/City:		County:
Postcode:
Phone Home*:		Phone Mobile:
Occupation:		email*
Date of birth: (dd-mm-yy)
Partner (only if this application is for a couple)
Title:
First Name:		Last Name:
Occupation:		Date of birth: (dd-mm-yy)

Current Sports and Social Interests:

Please identify your favourite sports here

1.*		2.
3.		4.
How did you hear about us?

	If Advert, Direct Mail, Exhibition, Flyer or Poster please state Marketing Code, who through or where seen:

Payment Details:

Membership Type	Cost(£)	VAT(£)	Total(£)
Individual	85.00	14.88	99.88
Couple *	76.50	13.39	89.89
Group of 3 to 9 friends or colleagues *	68.00	11.90	79.90
Group of 10 or more friends or colleagues *	51.00	8.93	59.93
Corporate (from)	500.00	87.50	587.50
Surcharge for payment by Credit card (Visa, MasterCard)	3.0%

I am paying by:

I confirm I have read the Terms & Conditions

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Action Scene Membership Application Form

Current Sports and Social Interests:

How did you hear about us?

Payment Details:

I am paying by: Cash/Cheque/Bank transfer Credit/Debit Card

I am paying by: