EMBER SPORTS CLUB

 

21A THE DRIVE   ESHER   SURREY   KT10 8DH     (Car park entrance beside 2 GROVE WAY)

 

 

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 C’tee:

 

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