Home of Lane Tennis Club
Affiliated to the L.T.A, Cheshire L.T.A.,
Warrington and District L.T.A.
Subscriptions
Highfield Road
WIDNES
Cheshire
WA8 7DW
Tel 0151-257 8317
All prices are inclusive of VAT increase
I / WE WISH TO APPLY FOR MEMBERSHIP OF THE LANE TENNIS CLUB FOR ONE YEAR FROM THE DATE OF JOINING FOR THE 2010/2011 SEASON AND WILL ABIDE BY THE CLUB RULES AND ETIQUETTE.FULL PLAYING MEMBER / £160 / Please tick
HUSBAND AND WIFE / £235
FAMILY (2 ADULTS + CHILDREN UNDER 16 OR IN FULL TIME EDUCATION LIVING AT THE SAME ADDRESS) / £275
STUDENT (OVER 16 AND IN FULL TIME EDUCATION) / £75
JUNIOR (UNDER 16YRS ON OR BEFORE 31 AUGUST). ONE LEGAL GUARDIAN MUST ALSO BE AT LEAST A NON PLAYING OR SOCIAL MEMBER. / £75
JUNIOR (SCHOOL YEAR 6 OR BELOW AT THE TIME OF JOINING). ONE LEGAL GUARDIAN MUST ALSO BE AT LEAST A NON PLAYING OR SOCIAL MEMBER. / £40
NON-PLAYING OR SOCIAL MEMBER (MUST BE OVER 18YRS) / £10
NAME :
PLEASE TICK THE APPROPRIATE BOX FOR THE TYPE OF MEMBERSHIP YOU WISH TO OPEN. PLEASE SEND BY POST THE COMPLETED FORM ALONG WITH A CHEQUE FOR THE MEMBERSHIP YOU REQUIRE MADE PAYABLE TO: " LANE TENNIS CLUB LTD” MEMBERS CAN PAY FAMILY AND HUSBAND & WIFE MEMBERSHIPS IN 4 EQUAL MONTHLY INSTALMENTS IN CONSECUTIVE MONTHS BY ISSUING FOUR POST-DATED CHEQUES. PLEASE DO NOT SEND CASH THROUGH THE POST. / DOES THE MEMBER HAVE ANY MEDICAL; ISSUES WE NEED TO BE AWARE OF? (if yes please provide details overleaf) / YES/NO
TOTAL PAYABLE
NAME
ADDRESS
POST CODE: / ARE YOU REGISTERED DISABLED? / YES/NO/
PREFER NOT TO SAY
TELEPHONE HOME: MOBILE:
Please advise email address, if available, as we can use this for future communications
EMAIL Address
DATE OF BIRTH (JUNIORS)
SIGNED
DATED:
SIGNED (LEGAL GUARDIAN FOR JUNIORS)
PLEASE TICK THIS BOX IF YOU OBJECT TO YOUR CHILD’S PHOTOGRAPHS BEING USED FOR ADVERTISING PURPOSES / I DO NOT WISH MY CHILD’S PHOTOGRAPH TO BE USED FOR ADVERTISING PURPOSES / Please Tick
Have you any criminal convictions which would prevent your application for membership from being approved by the Academy Committee? / NO / Yes
If yes please give details overleafe