MEMBERS DETAILS

FIRST NAME__________________________________ SURNAME_________________________________________

ADDRESS_______________________________________________________________________________________

TOWN________________________________________ COUNTY___________________________________________

POSTCODE___________________________________ D.O.B._____________________________________________

PHONE NUMBER______________________________ MOBILE____________________________________________

EMAIL ADDRESS_________________________________________________________________________________

Please tick if you wish to receive your monthly newsletter via email:

FAMILY / COUPLE MEMBERSHIPS ONLY

Fill in address and telephone details if different from details given above. Family membership consists of 2 adults & 2 children under 16 years old. Membership for additional children under the age of 16 years old is £2 per child

NAME 2_______________________________________________ ADDRESS___________________________________________________

D.O.B________________________________________________ PHONE______________________________________________________ _____________________________________________________

NAME 3_______________________________________________ ADDRESS___________________________________________________

D.O.B________________________________________________ PHONE______________________________________________________   _____________________________________________________

NAME 4_______________________________________________ ADDRESS___________________________________________________

D.O.B________________________________________________ PHONE______________________________________________ ___________________________________

TYPE OF MEMBERSHIP

Please circle the Price of the type of membership you are applying for below

                             SENIOR           JUNIOR               O.A.P                 DISABLED               COUPLE          FAMILY

NEW:                     £40                £25               £22.50p              £22.50p                £46                £55

*RENEWAL/:        £30                £21                  £20                     £20                      £36                £43

*ASSOCIATED

*Delete as appropriate

SIGNATURE - DATE JOINED

I/we understand that by signing this form that i/we agree to the constitution and all the rules of the club and I/we understand that if this application is accepted, if i/we break any of the club rules, then i/we could have my/our membership revoked, without financial refund.

Please provide 2 photographs for each person named on membership form.

MEMBERS SIGNATURE____________________________________ DATE______________