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YTFC Disabled Supporters Forum - "Help us to help ourselves!"
YTFC Disabled Supporters Forum Registration Form

In line with other Nationwide League clubs the Board of Directors require a complete record of ALL disabled supporters of Yeovil Town Football Club. It would therefore be appreciated if those supporters in this category would print this form out, complete it and return it either to the main office at Huish Park, or to: Irvin Morris, Honorary Disabled Supporters Liaison Officer, YTFC; at 8, Stanchester Way, Curry Rivel, Langport, Somerset TA10 0PS or FAX to 01458-250897, or simply email your details to Irvincb1@btinternet.com

PLEASE PRINT IN BLACK INK
Full Name:

Home Address:

Telephone Number (including STD code):

Mobile Number:

FAX Number (if applicable):

Email Address:

Nature of your disability: (Please indicate which is applicable)
Wheelchair
Ambulant
Blind
Deaf

Local Authority with which registered disabled:

Do you drive or are you driven to home matches? YES/NO

If YES - Please print your vehicle registration number:

Blue/Orange Badge Registration Number:

Are you a member of any of the following supporters organisations? (Please indicate as appropriate)
Vice Presidents YES/NO
Green & White Supporters Club YES/NO
Independent Supporters Association YES/NO

Are you a season ticket holder? YES/NO

If YES, which Stand? (Please indicate as appropriate)
Main Stand YES/NO
Bartlett Stand YES/NO
Westland Stand YES/NO

Block:
Row:
Seat Number:


Signed:

Date:

Please print name:


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