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Registering interest

This form is to register your interest in Later Lifestyle Clubs.

You can register your interest either to be an active founder member interested in helping set up and shape your local club, or simply as being interested in being a member of the club and participating in the facilities and activities it provides. 

If you haven't yet read the information about Founder Members and Participating Members on the Membership page please do so before completing this form.

Registering doesn’t commit you it just allows the discussion with others to take place. 

As a result of registering we will set up a login for you on the Later Lifestyle Network. We will usually use your first name and first initial of your last name as your username, if you would like a different username tell us in the additional information below (you can change username at any time).

Use the TAB key to move between fields

About you
First name:
Last name:
Email Address:
Contact Telephone No.:
Postal Address:
County:
Post code:

Are you interested in being a founder member, or a participating member? If a founder member would you consider being the leader?:

Are you retired/approximately how long have you been retired?
Additional information e.g. do you have a partner or friends you think would be interested?
(optional):
Questions/Comments e.g. any immediate reactions, comments or suggestions about the clubs, based on what you have read
(optional):

Are you happy for us to pass your contact details to anyone establishing a club in your area?

 
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