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West Ham United Disabled Supporters Association
Membership Form

Please complete the below form to join West Ham United's Disabled Supporters Association. Membership to join is free and is open to all with disabilities along with family and friends. Once signed up we will keep you up to date with latest news and events.

* indicates required

First Name

Last Name

Email Address *

Phone Number (optional)

Birthday

Month / Day

Address

Street Address Address Line 2 City State/Prov/Region Postal/Zip Country

Client Ref (If applicable)

How did you hear about us?