Month attending: (tick one box only, submit new form for each additional dinner meeting.) *
Required
Your name : *
Your answer
Membership Number: *
Your answer
Phone number:
Your answer
Name person 2 (leave blank if none)
Your answer
Membership Number person 2:
Your answer
I understand that myself and any persons accompanying me will be required to comply with any government or club regulations that may be issued regarding COVID in 2022 *
Required
A copy of your responses will be emailed to the address you provided.