New Application for Membership
Barnt Green Sports Club
Margesson Drive, Barnt Green,
Birmingham B45 8LR, Tel: 0121 445 1978
Email:
NEW APPLICATION FOR MEMBERSHIP
Personal Details:
Surname: ...... Title: ...... Date of Birth: ......
Forenames: ......
Address: ......
......
Post Code: ...... Tel No (Home): ......
Email: ...... Mobile: ......
Gold Membership Only:
Dependant Members:
Name: ......
DOB: ......
Emergency contact details: Name:...... Mobile:…......
Important Medical info:…......
Membership Details: (Please tick the relevant boxes).
Number of Sports____GOLD [ ]Social +[ ]Social Only [ ]
(All Sports/courts)
Member Type:Adult [ ] Junior (U21)[ ] Child (U11) [ ]
Concessions:F/T Student [ ]Distance [ ] Senior[ ]
(Max 30% discount) (Copy of NUS card(Resides more than 25miles (Over 65)
on application) away as the crow flies)
Sports applying for: (Gold, Junior & Child memberships automatically join all sports – please select your primary sport)
Badminton[ ] Squash/Racketball [ ] Tennis [ ] Table Tennis [ ]
Additional notes:......
......
……………………………………………………………………………………………………………………………………………......
Can Gold / Junior Members please indicate their Primary sport if applicable
I enclose a cheque/cash/BACS payment covering the joining fee, subscription fee – less any permitted discount, affiliation fees plus £1 (refundable) liability guarantee per member.
Joining fee: £……… + Subs £……… + Affiliation fees £…………. + Guarantee (£1 per member) £………..
= Total £…………………………………………
BACS: Acc no: 07788306 Sort Code: 30-96-12 (enter member name as ref)
For BACS payments by signing the declaration you agree to pay within 5 days of application.
Please make cheques payable to:Barnt Green Sports Club.
Alternatively – We accept Debit Card and Credit Card payments at the bar.
Declaration:
I apply for membership of the Barnt Green Sports Club. I agree to abide by the rules of the club and acknowledge that my details will be held on a computer database.
I understand that if my application to become a member of the Club is successful, I will be required to pay an annual subscription fee and a single one off payment of £1.00 representing my guarantee for the Club’s liabilities in the event it is wound up or otherwise becomes insolvent. The £1 payment shall be refunded upon my ceasing to be a member of the club and returned to me when I return my card.
I understand that membership of the Club (and the guarantee) terminates in any one of (or a combination of) the following circumstances:
1.1.Upon my death;
1.2.If at any time the conditions for membership of the Club no longer apply to me;
1.3.If I fail to pay the Membership Fee; or
1.4.Otherwise in accordance with the provisions of the Articles of Association of the Club.
By signing below, I confirm that:
- I agree to become a member of the Club limited by guarantee; and
- I authorise the Club, their authorised person and/or any otherauthorised third party to take any action required to complete the registration of my membership with the Club on my behalf.
Signed: ______
Name: ______Date: _____/_____/_____
Proposed by: ______
Signed: ______Date: _____/_____/_____
Seconded by: ______
Signed: ______Date: _____/_____/_____
Please note that the Club takes steps to ensure that your personal data is protected but the Management Committee recognizes that members need information to be able to contact each other. Accordingly, it is intended that a list will be displayed on the Club noticeboard showing each members name, telephone number and email address.
If you do not wish your telephone number and email address to be shown on the Schedule please notify the Club Steward. Even if you do not wish to have your email address disclosed to others, it is imperative that you give the Steward details of your email address to facilitate communication.
Please return completed form to the Club at the address above.