Junior Membership Application form

Penlee Park ⋅ Penzance ⋅ Cornwall ⋅ TR18 4HE Tel: 01736 367627
E-mail: [email protected]
www.penzancetennisclub.co.uk
JUNIOR MEMBERSHIP APPLICATION FORM
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April 1 2015 to March 31 2016
Subscription Categories (*please tick against appropriate category)
Junior 13-16*___
Junior 8-12* ___
Junior U8* ___
The information you provide will be treated securely and used only to promote the safe and efficient operation of Tennis Club activities.
As the form is applicable for the entire year, IT IS IMPORTANT THAT YOU TELL US IN WRITING OF ANY CHANGES.
By filling in this form, you are also being automatically signed up as a British Tennis member for free (tick opt out section if not wanted).
This will enable you to take advantage of the many benefits offered to British Tennis members including Wimbledon tickets, exclusive
news and discounts and a player rating. For more information visit www.LTA.org.uk/membership. By giving your consent to your child
becoming a British Tennis member, you agree that your child will abide by the Terms and Conditions of British Tennis Membership (at
www.LTA.org.uk/BTMTC) and that the LTA and its directly affiliated bodies (see www.LTA.org.uk/affiliatedbodies) can use the personal
data of your child, including sensitive personal data that you provide, for the purposes of your involvement in British Tennis and to send
you/your child by post, e-mail or SMS information related to those purposes (for more information see www.LTA.org.uk/privacy).
I wish to opt out of British Tennis Membership _____* (* tick here)
Please use a separate form for each child and write clearly
Surname
First name
Male/Female*
(*delete)
Address:
□□□□ □□□
Postcode:
Telephone:
Mobile:
Email (please write clearly!)
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Child’s age on January 1 2015
Date of Birth
Emergency contact name and tel. no.
Emergency contact name and tel. no.
Medical notes/special provision/travel sick etc. Please state here and use separate sheet as necessary.
201516 Junior New Membership Appl Form
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JUNIOR MEMBERSHIP SUBSCRIPTION CHARGES 2015/16
Junior 13-16
Junior 8 – 12
Junior U8
£84
£62
£23
NB. membership subscriptions are calculated on a sliding scale depending on the month of joining
for first time joiners only. Please ask at the office for sliding scale subscription details.
Parents/Guardian consent
I have read and fully understood the information contained in this form and have provided any additional information that I consider
relevant. I undertake to immediately inform the Membership Secretary in writing of any changes to the information provided on this
document. I consent to my son/daughter participating in any Tennis Club activity provided. I consent to my child travelling by any form
of public, contracted or private transport organised by the Tennis Club, if it is necessary to do so. I consent to first aid and emergency
medical treatment being administered to my child if required by suitably qualified personnel. We occasionally use photographic images
of tennis club activities, including participants, for promotional and reporting purposes. Such images are carefully vetted before use. I
consent to my son/daughter appearing in such photographs. The Tennis Club only provides supervision during organised activity
sessions, e.g. coached sessions and the junior club evening. I understand that the Tennis Club’s responsibility commences at the time
my child’s organised activity commences and ceases at the time my child’s organised activity ceases. I am aware that it is my
responsibility to arrive on time for both delivering and collecting my child from Tennis Club activities.
Data Protection
We hold names and addresses and basic medical information that you give us in order to safely and efficiently administer Tennis Club
activities and to take relevant action in the event of an emergency following Data Protection Act 1998 principles and requirements. We
keep this information for up to 12 months. This information will only be made available to appropriate Officers of the Tennis Club and
our membership management service provider and we will not share this information with anybody else without your permission. We
may use this information to contact you about future Tennis Club activities
GIFT AID
Do you know that if you are a tax payer you can Gift Aid donations that is any amount over and above
subscriptions, to Penzance Tennis Club? As an HMRC registered Community Amateur Sports Club
(CASC) the Club will receive an extra 25 pence for every pound you donate under the HMRC Gift Aid
Scheme http://www.hmrc.gov.uk/individuals/giving/gift-aid.htm at no extra cost to you!
If you are a higher rate tax payer then the Club and you, can benefit by giving.
More information and Gift Aid application forms are available from the office and our website.
Cheques made payable to “Penzance Tennis Club”
Cheque £_________enclosed
Subscriptions are non refundable. Any appeals should be made to the committee in writing.
Signed _________________________________________________Date_____________________________________
Print Name ______________________________________________________________________________________
By signing I agree to abide by Club & LTA Rules http://www.lta.org.uk/Footer/about-us/Policies-and-rules/LTA-Rules-and-Regulations
Office hours: Monday 1.30-5pm
201516 Junior New Membership Appl Form
Tuesday 1-5pm Wednesday 9am-1pm , 1.30-3pm Friday 1-3pm
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