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Monday, 27 March 2017

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BLSA Membership Sign Up

To become a member of the BLSA, please enter your details below Please make sure you select the correct membership type from the drop-down box in the form below.

Alternatively, if you do not want to become a full member and just want to receive newsletters from us, or to make a purchase from our online shop, click here.


Log In Details
   
Enter a username: *
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Confirm your password: *
   
Personal Details
   
First Name * :
Surname * :
Date of birth *:
Sex *:
 Male    Female
   
Address Details
   
Address * :
 
 
Town / City * :
County :
Postcode * :
Country * :

Telephone :

Mobile :
   
Membership Details
   
Please choose the type of membership you require from the list below.
   
Membership Type * :   

Sport * :  Blokart
 Speedsail
 Blokart/Speedsail

Sail Number:  
Glasses / Contacts * :  None
 Glasses
 Contact Lenses
 Both

Emergency Contact Name * :
Emergency Contact Number * :
Medical / Allergy Info :
Upload Passport Photo :
   
E-mail Settings
   
E-mail Address * :
Preferences:
Please e-mail me news updates

* I agree to the site Terms & Conditions and will abide by the BLSA Code of Conduct.
   
   
Image Verification
   
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Please enter the text you see in the image (all letters are upper case)