Your Passed Relative Details:

Passed Relative Name*

Date of Birth*

Place of Birth*

Date of Death*

Place of Death*

Details*
Please write a short description of how the person was involved in the club. (If Member, if part of the committee, what years, etc) [/textarea]
Please submit a photo of your passed relative*

_________________________
Your Details
Your Name & Surname*

Relationship to Passed Relative

Your Email*

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