Full Membership Application Personal Details Title Full Name Address Postcode Phone Mobile email Birth Date**
Handbook* Yes / No
I am a student in full time education
Yes Yes Yes Yes
/ / / /
No No No No
*NMC Handbook: Please indicate which details you wish to be included in the members’ handbook. ** Under 18s: Please confirm that the Under 18 policy & in loco parentis forms have been read and signed.
Your Climbing Experience: Can you safely and responsibly belay and lower a top-roped climber? Please briefly describe your climbing experience:
Yes / No
NMC Meets attended or equivalent: (Location/Date) 1 2 3
Proposal In our opinion the applicant can climb and belay safely and responsibly and we therefore recommend that the committee approve their Full Membership of the NMC. Proposed by Seconded by Name Signature Date
Participation Statement The NMC recognises that climbing, hill walking and mountaineering are activities with a danger of personal injury or death. Participants in these activities should be aware of and accept these risks and be responsible for their own actions and involvement.
Declaration In applying for membership I confirm that I have read and understood the NMC participation statement, and am fully aware of the activities involved and the risks entailed.
(Parent or Guardian to sign if applicant is under-18)
Full Membership is currently £23 per membership year or £8 if upgrading from Prospective to Full. The membership year runs from 1st March to end of February. Applications and renewals are to be sent to the NMC Membership Secretary by email (preferred) or post; payment via direct debit can be authorised here: https://dashboard.gocardless.com/api/paylinks/0872P9H93J Adrian Wilson, NMC Membership Secretary, 23 Hamsterley Drive, Killingworth Tel: 07970 823 483 Newcastle upon Tyne, NE12 6TB Email: email@example.com