Please complete the form below and submit your first payment. This will set up a recurring monthly payment. Dan Y Coed 100 Club RegistrationName(Required) First Last Mother lodge nameE.g Dan Y Coed LodgeCurrent position / title(Required)E.g. Worshipful Master, Secretary, etc.Email(Required) Contact number(Required)Please note, we will only use this information to notify you if you win one of our draws.100 Club number registration Quantity(Required)Please note that you can purchase as many numbers as you wish, and these will be allocated to you shortly after your subscription. Price: £ 3.00 Quantity Total Before you hit purchase & subscribe below, please remember this is a recurring monthly payment. The amount stated above will be taken each calendar month on the same date as your first payment, and your allocated numbers will be entered into our competition draws. If you cancel at any time, your name and numbers will be removed and you will not be entitled to a refund.