I confirm that I have set up a regular payment i.e. online banking payment or standing order on the dates above to The O.S.A. 300 Club to HSBC Bank Sort Code 40-40-22 Account Number 91745719 (please note we cannot accept Direct Debits). Please quote your surname and 300 Club as your reference. I understand that if I fail to pay any of the regular payments I will not be entered into the next draw or any further, until such time as payments are brought up to date or I confirm my intention of withdrawing from the Club. *