I wish to become a member of RoSPA Coventry Riders.

Name:

DOB:

Address:

Postcode:

Email:

Mobile:

When did you pass your DSA test:

When are you most likely to be available for training, i.e. Weekdays, Weekends or either:

Motorcycle Details (Make, Model, cc):

Please give details of previous riding experience e.g. numbers of years riding plus any other advanced training and why you want to pursue the RoSPA Gold riding qualification:

I heard about the group from:

Your personal data will be used by RoSPA Advanced Drivers and Riders Coventry Riders for the purposes of supporting your progression to undertake a RoSPA assessed test as an associate member. Upon becoming a full member your data is used to continue to support your development as an advanced rider. Your personal data is held by the training officer and will be shared with your tutor. Your contact details are accessed by the committee membership for the purposes of keeping you informed on training and social activities, group news and safety-related matters by E-mail, telephone, or post.

Please tick to confirm you accept how your information is held and used hereagree