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Membership Form 2012 2013 new

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Membership Form 2012  2013 new Powered By Docstoc
					                    WOLVERTON SPORTS CLUB
                         Tennis Section
                  OSBORNE STREET, WOLVERTON, MILTON
                                  KEYNES.
                       Tel.: M.K. 313866 – Club House
                       Mobile: 07954238211 - Enquiries
                       www.wolvertontennisclub.co.uk

                          Application for Membership
                         1 April 2012 – 31 March 2013
                    (including British Tennis Membership)
Please tick
  ______        Senior Playing Member                        £ 110.00*
  ______        Mini Tennis (10 and under at 1 April 2012)   £ 27.00
  ______        Juniors (11 – 18 incl at 1 April 2012)       £ 32.00
  ______        Intermediates (18+ and in f/t education)     £ 55.00
  ______        Family Membership                            £ 250.00*
  ______        Daytime Membership (Mon-Fri, 9am-5pm)        £ 55.00
                          TOTAL AMOUNT PAYABLE               £ ______

     Name 1: ………………………………………Date of Birth:.……..….………
     Name 2: …………………………...………… Date of Birth:..……….…….…
     Name 3: ………………………………………Date of Birth:…………………
     Name 4: ………………………………………Date of Birth:…………………
     Address: ………………………….……………….…………….……...………
      ……………………………………..…………………….………….………….
     Tel No (Home): …………………..…………...…….…….………....…………
     Tel No (Mobile): ………………………………..…………………..…….……
     E-mail address: ……………….……………………….………….…………….

                Are you interested in Match Play          Yes / No
          if Yes please contact Pete Tolaini on 0774 0004548

               How did you hear about the Club? Please circle below:

  LEAFLET / BANNER ON FENCE / WOLVERTON & GREENLEY NEWS / A FRIEND / WEBSITE

  For under 18’s please indicate on the back of this form any medical conditions the coach
  should be aware of, such as nut allergy, asthmatic etc.
* Senior and Family fees can be paid by three post-dated cheques, the first being at the end
  of the month of joining, and then the end of the two following months i.e. for existing
  members and new members joining in April the dates are: 30 April, 30 May, and 30 June.
  Please make cheques payable to: Wolverton Sports Club Tennis Section, and send with
  this form to: Martin Hodges (Treasurer), 52 Malvern Drive, Fullers Slade, Milton Keynes,
  MK11 2AE (by post) or; 9 Stacey Avenue, Wolverton (by hand)
 British Tennis Membership: If you are already a BTM member please enter your
 membership number here ……………….. , if not, please read on. The BTM is the LTA’s
 scheme for individual participants in tennis. As Wolverton Tennis Club is affiliated to the
 LTA, by joining the club, you also become a British Tennis Member, currently at no
 additional cost. If you do not wish to be a member of BTM please tick this box .

  PTO for BTM benefits, Data Protection and Terms and conditions
      British Tennis Membership
      The benefits of British Tennis Membership include entry into the club ballot for Wimbledon
      tickets, a player rating; a Team Card (which is a way of collecting points when you shop
      which you can redeem against tennis equipment) and discounts on tennis tickets (e.g. Davis
      Cup) … to name a few.

      Data Protection Statement
      By signing this form, unless you have indicated that you do not wish to be a member of the
      BTM, you agree that the LTA and its national, county and island associations can use your
      personal data, including sensitive personal data, for membership purposes and to send you
      by post or email or SMS information related to those purposes. For further details please see
      www.lta.org.uk/privacy.

      To help raise funds for tennis, the LTA may also wish to do the following (please tick the
      appropriate box if you do not want the LTA to):

          send you information about LTA offers and about offers from carefully selected third
           parties by post/email/SMS 
          pass your contact details to carefully selected third parties so that they can send you,
           by post, details of their products and services 

      Terms and conditions
      The Terms and Conditions of British Tennis Membership can be accessed at:
      www.lta.org.uk/BritishTennisMembership/Termsandconditions.pdf or from your club
      secretary.

      By signing below I agree to:-

           Become a member of Wolverton Tennis Club, and unless opting out, also British
            Tennis Membership
           Abide by the Club rules and the terms and conditions of British Tennis
            Membership
           The Data Protection Statement above

      Signature _________________________________________________

      Signature of parent or guardian (if under 18) _____________________




Under 18s - Medical Conditions etc:

				
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