APPLICATION FOR MEMBERSHIP – 2018/19

Thank you for applying for membership of SportsAble. Please complete the details below and overleaf, then return the form with the appropriate fee to the Membership Secretary, SportsAble, Braywick Sports Ground, Braywick Road, Maidenhead, SL6 1BN.

Section A (Please Print)

Mr/Mrs/Miss/Ms Name: ……………………...... …...... Surname: ………….……………………......

Address: ………………………………..……………………………………………………………………......

Post Code: …………………...... Date of Birth: ......

Telephone Number: (H)…………………………………… (M)......

Email: ……………………………………………………......

Emergency Contact Name:...... Emergency Contact Number: ......

School Attended (juniors only)......

Ethnicity:......

Section B – Membership Fees:

SPORTS MEMBERSHIP

Individual Disabled £75.00 Individual Non-Disabled £75.00 

Sports Family Membership £225.00 

(Family = 2 adults and 2 children under 18 – each requires an application form)

Intended Sport(s): .………………………......

SOCIAL MEMBERSHIP

Individual Disabled £38.00 Individual Non-Disabled £38.00 

Social Family Membership£115.00 

OTHER MEMBERSHIPS

Associate Members (limited number offered and applies to a single sport only)£38.00 

(Open to members of organisations belonging to Braywick Sports Ground User Groups -by invitation only and on a reciprocal basis)

Applicants should note that they participate in sport at their own risk prior to their application beingformally accepted by SportsAble. ALL NEW MEMBERSHIPS CARRY A THREE-MONTH PROBATIONARY PERIOD.

Section C – Medical Details (All Applicants):

Please note that SportsAble reserves the right to refuse membership on medical grounds or to suspend and / or cancel membership if there are changes in medical conditions.

Clinical Diagnosis: …………………………………………………………………......

Disability: ……………………………………………………………………………......

Any other relevant factors (e.g. Haemophilia, Heart Disease, Asthma, Epilepsy, Diabetes, Allergies): ………………………………………………………………………………………………………………………….

D.S.E. Profile Number or classification, if known…………………………………......

Section D ALL APPLICANTS SHOULD NOTE:

  • Except in respect of death or personal injury caused by the negligence of SportsAble or any officer of SportsAble acting as such, neither SportsAble nor any such officer shall be liable for the death of, personal injury to or financial loss suffered by, any member of SportsAble arising out of or in connection with any activity or event organised or carried on by SportsAble either alone or in co-operation with any organisation, and participation in any such activity or event shall be entirely at the member’s own risk.
  • SportsAble reserve the right to refuse applications for membership.
  • The information you provide will be stored on a computer database to be used for Club purposes only

How did you hear about SportsAble? How should we communicate with you?

SportsAble WebsiteEmail

Other Website (please specify)Text

...... Phone

Word of Mouth / RecommendationPost

...... Please select your preferred option

Advertisement (please specify where seen) 

......

SportsAble has my permission to use my photograph, video and audio recordings, likeness, artwork, profile and/or story in this and future publications, websites, social media and other promotional materials produced, used by and representing SportsAble. YES  NO

I APPLY FOR MEMBERSHIP OFSPORTSABLE AND IF ACCEPTED, AGREE TO ABIDE BY THE RULES OF THE CLUB. MY PROPOSERS FOR SPORTSABLE MEMBERSHIP (SPORTSABLE MEMBERS FOR AT LEAST 1YEAR) ARE:

1.Name......

2.Name......

Applicant’s Signature………………………………...... Date……………………......