The

The Gate

Tel:ase 07812 782294 for a membership form to be sent to you.

First Name: _____________________ Surname: ____________________

Address: ___________________________________________________

______________________________________ Postcode: _____________

Contact Number: _____________________________________________

Email Address: ______________________________________________

2^nd Member

First Name: ____________________ Surname: _____________________

Address: ____________________________________________________

_______________________________________Postcode: ____________

Contact Number: _____________________________________________

Email Address: _______________________________________________

Please indicate whether you are happy to receive information by

Post YES/NO Email YES/NO (please delete as appropriate)

We confirm that we are over 21 years of age & that we understand that The Gate is a fetish club where Bondage, Discipline, or Dominant/ Submissive may play take place between consenting adults. We confirm that we will not be offended or affronted by any of the activities that take place.

1^st Member SIGNATURE: _____________________________________

2^nd Member SIGNATURE: _____________________________________

By signing this form I/We have read and agree to abide by the club rules and conditions.

Once completed please post to: c/o 3 Dover Road, Northfleet. Kent. DA11 9PH

Membership:Couples £30.00: Singles£20.00 per person per year.

Please make Cheques made payable to Ms J Betts