sparklingcompany Register today

Sparkling Company

Special Events for Single Like-Minded People

For Good Food, Fun and Friendship

please print a copy of the Sparkling Company Membership form

MEMBERSHIP FORM

Name				Mr Mrs Ms
Full Address
Contact Numbers :	Day/ Evening		Mobile		Email
D.O.B.	Height		Weight		Marital Status
Nationality	Religion		Occupation		Children Yes/No
Hobbies/Interests
Any Strong Views (e.g. political) or dislikes?
Are there any foods you do not eat?
Smoker? YES / NO		How Did You Hear About Us?
Next of Kin or Emergency Contact, Address and Phone Number
Any Medical Conditions
Any photos showing me at events can be used to promote the website YES / NO

To continue your Registration, please provide

· two passport-sized photos

· payment of £100.00 per annum membership fee

· Post to Sparkling Company, Southfields Farm, Kenilworth Road, Balsall Common CV7 7HB

or bring to monthly meeting at the Greswolde on the 1^st Thursday of each month.

Registration is only finalised once all the above stages have been completed.

On successfully becoming a member you will receive a receipt of payment, followed by confirmation, and will be invited to join our events.

Any breach of the ethos of Sparkling Company will result in termination of membership and no refund will be provided.

I agree to the above conditions YES / NO

Signature _______________________________ Date __________________________

Office Use Only

Membership Fee Received Photos Received Membership Card Issued

For more information

Telephone 07790 758 653 or E-Mail - info@sparklingcompany.com

Kenilworth Road, Warwickshire.