Membership Request Form

Please fill in all requested areas of the form.

First Name
Middle initial/s
Surname.
E Mail
Address Line 1
Address Line 2
Address Line 3
Address Line 4
Postcode/ZIP
Country



Would You Like To Choose Your Username & Password?					Do You Currently Own A Grifter ??

		Yes		No	Yes	No

If Yes, Please Enter Username and Password Below					Do You Own More Than One Grifter

		Username			Yes	No
		Password

Is/are Your Grifter/s Listed In Our Register

Yes	No

Please Let us know the follwing information

Yes I Understand that My Membership if accepted will be subject to a period of probation and subject to user guidelines
No, i do not understand why My Membership if accepted will be subject to a period of probation and subject to user guidelines

If You Answered NO to the above question, we will e-mail you with the explaining the reasons for the probation period and user guidlines

We thank you for taking the time to complete this form. We ask, that if you own a Grifter, that you add it to our register.
This way, we all have an area where we can view who owns these cycles and just how many are left in existence
We endeavour to reply swiftly and without delay.

PLEASE NOTE
Your information will NOT be passed onto third parties, but remain in a database.
This information is member Specific, available upon request, should you forget your Membership Details