Registration of Clubs (Ireland) Act, 1904

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SECOND SCHEDULE.

Form of Certificate of Registration of Clubs to be granted under this Act.

Section 3 .

Certificate of Registration.

I,          Registrar of Clubs, hereby certify that the          Club, of*           , is registered under the Registration of Clubs (Ireland) Act, 1904. This certificate remains in force till the          day of          , 19          ; application for its renewal must be made not later than the          day of          , 19     .

Given under my hand this          day of          19     .

Registrar of Clubs.

* Fill in registered postal address of all premises used by the club.