I Understand That a Notice of Cancellation Is Required in Accordance with the Cancellation

Name:
Address:
Postcode:
Home: / Work:
Mobile: / E-mail:
BASC Membership No: / Valid to:
DSC 1 Certificate Number:
Please enclose a copy of your DSC1 certificate
Rifle Calibre: / Weight of bullet:
Firearms Certificate No:
Constabulary & issue date: / Trained Hunter*
Registration number:
*Your trained hunter number is either your DSC1 number or your Lantra /NGO number, depending on where you have completed your meat hygiene training.
Please clearly indicate your chosen event(s) @ £170.00 per event:
Event 1 August 5th & 6th2014 / Event 8November 25th & 26th2014 / Event 15April 21st & 22nd2015
Event 2August 19th & 20th2014 / Event 9December 9th & 10th 2014 / Event 16 May 12th & 13th2015
Event 3 September 2nd & 3rd2014 / Event 10December 16th & 17th 2014 / Event 17 May 26th27th2015
Event 4 September 16th & 17th 2014 / Event 11January7th8th2015 / Event 18June 9th & 10th 2015
Event 5September 30thOct1st 2014 / Event 12January 13th14th2015 / Event 19June 23rd & 24th 2015
Event 6October 29th & 30th2014 / Event 13March 10th & 11th2015
Event 7November 11th & 12th2014 / Event 14March 25th & 26th2015
Declaration

• I understand and accept the general conditions and have retained a copy for my own reference. I will not be

accompanied by a third party.

• If permission is granted, I undertake to indemnify BASC and the Land Owner against all claims for loss, injury or damage that may result from the exercise of the Permit.
• I understand that a Notice of Cancellation is required in accordance with the cancellation policy

and that penalty fees are likely to apply.

• I understand that I must hold DSC Level 1, and the Game Meat Handling qualification.

SignatureDate:

Revised 29.9.14