EMBER
SPORTS CLUB
21A THE DRIVE ESHER
SURREY KT10 8DH (Car park entrance beside
MEMBERSHIP
APPLICATION FOR THE 12 MONTHS FROM 1st APRIL 2010
I
hereby apply to join EMBER SPORTS CLUB and, if approved, agree to abide by the
Rules of the Club and by the Rules of any Section of the Club to which I am
elected.
Mr/Mrs/Miss/Ms.
.
.
D.o.B if under 18
(first
name / surname)
Address
...
.
Postcode
..
..
.
Home
phone
Mobile
phone (optional)
.
...
E-mail
address (for internal club use only)
.......
......................
...
Signed
..
..
..
Date
.
Signed
by Parent if applicant under 18
Date
.
How
did you hear about Ember? ........................................................................................................................................................................
SECTION
|
CATEGORY
|
TICK
HERE
|
AMOUNT
DUE
(see
rates overleaf) |
|
BOWLS |
ANNUAL |
|
£ |
|
CROQUET |
ANNUAL |
|
£ |
|
DRAMA |
ANNUAL |
|
£ |
|
TENNIS |
STANDARD
ANNUAL |
|
£ |
|
|
FAMILY
ANNUAL* *See
supplementary form |
|
£ |
|
|
MIDWEEK
ANNUAL (Monday
Friday only) |
|
£ |
|
|
STUDENT
ANNUAL (18-25
in full-time education) |
|
£ |
|
|
JUNIOR
ANNUAL (under
18) |
|
£ |
|
|
WINTER
STANDARD (October
March only) |
|
£ |
|
|
WINTER
MIDWEEK (Oct
March Monday Friday only) |
|
£ |
|
SOCIAL
ONLY |
ANNUAL |
|
£ |
|
|
TOTAL
PAYABLE
|
|
£ |
Proposer:
(please print) |
|
If you do not
already know anyone in the club who can propose and second your application,
please leave blank. |
|
Seconder:
(please print) |
|
||
Approved
by Section Ctee:
|
|
Date
approved:
|
|
PLEASE SEND
COMPLETED FORM AND CHEQUE PAYABLE TO EMBER SPORTS CLUB
TO
THE APPROPRIATE SECTION CONTACT AS SHOWN OVERLEAF.
IF YOU HAVE ANY
QUERIES, PLEASE CONTACT MALCOLM BAIRD ON 020 8398 4622
applic form front 2010/11