MEMBERSHIP APPLICATION FORM

Please register me as a member of thewayoutclub.com and send me a membership card, plus regular news letters.

PLEASE FILL COMPLETELY AND PRINT CLEARLY AND THEN SEND IT TO:

The WayOut Club Dot Com,
P.O.Box 70, Enfield EN1 2AE

Members name.....................................................................

Name for mailing (if different)...........................................

e -mail address.....................................................................

Mailing address....................................................................

..................................................................................................

..................................................................................................

Post Code..............................................................................

Signature...............................................................................

Date.........................................................................................

Send cheque or postal order made out to 'WayOut' for £35.00

Credit card type.........................

Credit card number ................/.............../............../............

Expiry Date .............../................

Switch issue number (if applicable) ..............................

Security last three digits on white strip ........./......../..........

Name on card.......................................................................

Address card registered to.......................................................................

Postcode.......................................................................

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What You Get:

You receive a £2 entry discount after 11pm
(If you are 'cross-dressed' you receive £5 entry discount).

We do not remind you when your card expires, but we do check at reception, the full entry fee will be required until renewal is paid. All information supplied to thewayoutclub.com is kept strictly confidential and none of your details will be released to any other organisation. Management of the thewayoutclub.com reserve the right to refuse admission. Management of thewayoutclub.com venue reserve the right of admission.