Membership Form: by Y3NBqD

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									                                                                    2012 Membership Form



Principle Member Details:
                           Title
                     First Name
                        Surname
          House Number / Name
                         Street
                           Town
                         County
                      Post Code
            Home Phone Number
           Mobile Phone Number
                  Email Address
                   Date of Birth

Membership Type Required (Please Tick One):
                        Adult Membership                            £     99         + £48 BWSF
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                        Family (2 Adult, 2 Child) Membership        £    199         + £84 BWSF
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                        Small Family (1 Adult, 1 Child)             £    150         + na BWSF
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                        Student Membership                          £     75         + £24 BWSF
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                        Child Membership (under 16)                 £     49         + £18 BWSF
                                                                        Upfront         Direct Debit
                        *Adult Membership                           £   575         £            50
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                        *Family (2 Adult, 2 Child) Membership       £ 1,449         £           149
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                        *Small Family Memerbship (1Adult, 1Child)   £   885         £            78
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                        *Student and Forces Membership              £   469         £            43
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                        *Child Membership (under 16)                £   469         £            43
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                        6 Month Membership (May 1 - Oct 31)         £      65
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*A £100 one-off joining fee is payable per cable member (one payment per family membership)

Please include details of additional family members below
               Family Member Name                                            Date of Birth
2nd Adult
Child 1
Child 2

Date for Membership to Commence

If you are already a British Water-Ski member please enter your
membership number below
Please make Cheques payable to ‘The Barbour Partnership’ and send completed forms to:
Box End park, Box End, Kempston, Bedford, MK43 8RQ
As a participant I am aware and understand that waterskiing is an action sport and carries a risk
of personal injury. I hereby release Box End Park owners, employees, instructors and equipment
from any and all liability of damages, both in law and equity, resulting from personal injuries
Signed                                                                        Date


Office Use:
Date for DD to commence =
                      th
Pro Rata amount to 15 of Month           £                     (        days @               per day)
   st
+ 1 full Month advance payment           £
+ £100 Joining Fee                       £
= Total taken at till

								
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