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LERWICK SQUASH CLUB MEMBERSHIP FORM – 2008/2009

 

MEMBERSHIP TYPE PLEASE TICK BOX AS APPROPRIATE

 

ADULT - £5

 

 

JUNIOR - £3

 

 

PERSONAL DETAILS PLEASE USE BLOCK CAPITALS

 

SURNAME:

 

MR/MRS/MISS/Ms

FIRST NAME:

 

DOB: (DD/MM/YY)

 

 

 

 

 

 

ADDRESS:

 

 

 

 

 

POST CODE:

 

 

 

 

 

 

 

 

E-MAIL:

 

HOME TEL:

 

 

 

 

 

 

 

 

 

 

 

 

WORK TEL:

 

 

 

 

 

 

 

 

 

 

 

 

MOBILE:

 

 

 

 

 

 

 

 

 

 

 

 

                                                 

 I wish to apply for membership of the LERWICK SQUASH CLUB and will abide by the club rules. I do not object to the information above being held and used to receive information from the club.

 I enclose my CHEQUE/CASH for £__________

 SIGNATURE: _________________________________  DATE: ____/_____/_____

(If under 18 Parent/Guardian)

 PLEASE MAKE CHEQUES PAYABLE TO “LERWICK SQUASH CLUB” and mark your envelope for LSC MEMBERSHIP FORM and send/deliver THIS PAGE ONLY with your cheque/cash to CEE & JAYS, 5 COMMERCIAL ROAD, LERWICK, ZE1 0LX.

  FOR OFFICE USE:

Application form & subscription received: £_________ Cash/Cheque on ____/_____/___

 

Membership No: