Aberystwyth Lawn Tennis Club Membership 2015

Aberystwyth Lawn Tennis Club Membership 2015-2016
Please complete in BLOCK CAPITALS. Membership runs from
Title:
Miss Mrs Ms Master Mr Other:
First Name:
Associate Parent Name:
st
st
April 1 2015 – 31 March 2016
Date of Birth & School Year:
DD/MM/YYYY
Surname:
(Primary school age membership only)
Address:
Town:
Post Code:
Telephone:
Mobile:
Email:
Does the applicant have any medical conditions that the club should be aware of? Please give details below:
Membership Categories
ü
Family members: please complete a separate form for each playing member of your family
Senior Individual Membership
£90.00
Secondary School Age Membership
Primary School Age Membership
£35.00
*Please complete consent section below
£20.00
(includes associate parent/guardian)
Student Membership – Open to those in full -time University education
£35.00
Family Membership– includes 2 adults and their children. Lead Member
£140.00
Family Membership Partner/Junior.
£0.00
Please supply lead members name below
Country Membership – living more than 30 miles away
£50.00
Country Family Membership – living more than 30 miles away
£80.00
Concessionary Membership -
£20.00
Available to job -seekers and those claiming benefit
Lead Member:
I/W e confirm that I/W e wish to join Aberystwyth LTC and agree to abide by the rules of the club
Signature__________________________________________________
Signature of parent or guardian (if under 18)
Date: ___________________
____________________ __ Date: ___________________
*Consent for Secondary School Members
By signing below I give permission for ________________________ to play tennis at Aberystwyth Lawn
Tennis Club unsupervised.
Signature of parent or guardian___________________________________ Date: ___________________
Payment:
I enclose a cheque for £
payable to ‘Aberystwyth Lawn Tennis Club’
Please send completed application & payment to:
June Blake, Membership Secretary, Ty Capel, Tynygraig, Ystrad Meurig. SY25 6AE
W elcome to Aberystwyth Lawn Tennis Club
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