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Annual Club Membership 2010

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Annual Club Membership 2010 Powered By Docstoc
					                                                                                                                                   Annual	
  Club	
  Membership	
  
                                                                                                                                         Application	
  and	
  Renewal	
  
                                                                                                                                                                              2010	
  	
  
                                                                                                                                              NEW	
  MEMBER	
   	
  	
  	
  	
  	
  	
  MEMBERSHIP	
  RENEWAL	
  


        	
  
        	
  




                                                                                                     	
                                                                      	
  
        	
  

        	
  
        	
                                                                                	
  
        	
                                                                                M E M B E R S H I P 	
   C A T E G O R Y 	
  
                                                      Category	
  A	
  	
  	
  	
  	
  
                                                      	
  
                                                                                          1	
  Junior	
  member	
  (17	
  years	
  and	
  under)	
  and	
  1	
  Senior	
  member	
                                                   $50.00	
  
                                                      Category	
  B	
  	
  	
  	
  	
  
                                                      	
  
                                                                                          Each	
  additional	
  Junior	
  member	
  	
                                                                                               $25.00	
  
                                                      Category	
  C	
  	
  	
  	
  
                                                      	
  
                                                                                          1	
  Senior	
  member	
  (18	
  years	
  and	
  over)	
                                                                                    $35.00	
  
                                                      Category	
  D	
                     1	
  Senior	
  member	
  (non	
  skater)	
                                                                                                 $35.00	
  
                                                      	
  
        	
  
        	
   	
   	
   	
   	
   	
   	
   	
                                             P A Y M E N T 	
   D E T A I L S 	
   	
  
        	
                                                                                Cash	
  	
  	
  	
  	
  	
  Cheque	
  	
  	
  	
  	
  Money	
  Order	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  Total	
  enclosed	
  $	
  __________	
  
        	
                                                                                Place	
  your	
  application	
  form	
  and	
  payment	
  in	
  a	
  sealed	
  envelope	
  marked	
  attention	
  to	
  the	
  	
  
        	
                                                                                Membership	
  Officer	
  and	
  place	
  in	
  the	
  Club	
  Mail	
  Box	
  in	
  the	
  Coffee	
  Shop.	
  	
  
        	
  
                                                                                          The	
  first	
  Junior	
  membership	
  per	
  family	
  must	
  be	
  accompanied	
  by	
  a	
  Senior	
  membership	
  (parent)	
  	
  	
  	
  	
  	
  	
  	
  	
  
                                                                                          for	
  voting	
  purposes.	
  Please	
  list	
  name	
  of	
  Senior	
  member	
  first.	
  
        	
  

                                                                                                                                                                                                        Membership	
  
                                                                                                                                                                                                                                         Membership	
  
                                                                                                                        Name	
                                         Date	
  of	
  Birth	
             Category	
                       Number	
  
                                                                                                                                                                                                         (CIRCLE)	
  
                                                                                            	
                                                                        	
  
                                                                                                                                                                                                       A	
   B	
   C	
   D	
                        	
  
                                                                                            	
  
                                                                                            	
                                                                        	
  
                                                                                                                                                                                                       A	
   B	
   C	
   D	
                        	
  
                                                                                            	
  
                                                                                            	
                                                                        	
  
                                                                                                                                                                                                       A	
   B	
   C	
   D	
                        	
  
                                                                                            	
  
                                                                                            	
                                                                        	
  
                                                                                                                                                                                                       A	
   B	
   C	
   D	
                        	
  
                                                                                            	
  
        	
  
        	
  

       P	
  U B L I C I T Y 	
   C O N S E N T 	
   	
                                    Home	
  Phone	
  	
  _____________________	
  	
  	
  Mobile	
  	
  _____________________	
  	
  	
  	
  	
  
       I	
  	
  give	
  BFISC	
  permission	
  to	
  take	
  my	
  
           	
  
       photograph	
  for	
  publication	
  in	
  the	
  	
                                Address	
  	
  ______________________________________________________	
  	
  
           	
  	
  
       Club	
  Newsletter,	
  website,	
  notice	
  board	
  
           	
  
       and	
  any	
  other	
  skating	
  /	
  club	
  related	
                           Email	
  	
  	
  	
  	
  	
  ______________________________________________________	
  
                           	
  
       material.	
  	
  
                                                                                          I	
   hereby	
   wish	
   to	
   apply	
   for	
   membership	
   of	
   Boondall	
   Figure	
   Ice	
   Skating	
   Club	
   Inc.	
   and	
   agree	
   to	
   abide	
  
       Please	
  tick	
  this	
  box	
   	
                                              by	
  the	
  Club’s	
  constitution	
  and	
  regulations.	
  I	
  nominate	
  Boondall	
  Figure	
  Ice	
  Skating	
  Club	
  Inc.	
  as	
  the	
  
       	
                                                                                 club	
  I	
  will	
  represent	
  in	
  all	
  competitions	
  throughout	
  2010	
  and	
  agree	
  that	
  I	
  will	
  not	
  apply	
  to	
  other	
  
       	
                                                                                 clubs	
  I	
  may	
  belong	
  to	
  for	
  financial	
  assistance	
  for	
  State/National	
  Championships.	
  
       	
   	
  
       V	
   O L U N T E E R S 	
   N E E D E D 	
   	
  
       Yes,	
  I	
  would	
  like	
  to	
  assist	
  the	
  	
   	
                       Name	
  	
  ___________________	
  Signature	
  	
  ________________	
  	
  Date	
  ______
       Club	
  where	
  possible.	
  	
  	
  
                                                                                              Office	
  Use	
  Only	
  
       Please	
  tick	
  this	
  box	
   	
                                                  	
  
	
                                                                                            Nominated	
  by	
  	
             	
  _____________________	
  	
  	
  Seconded	
  by	
  	
  	
  	
  	
  ____________________	
  
	
                                                                                            	
  
	
                                                                                            Receipt	
  Number	
  	
  	
   _____________________ Approval	
  Date	
  	
  ____________________	
  

				
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Description: Annual Club Membership 2010