MEMBERSHIP FORM

Player Full Name

Player Date of Birth (YYYY/MM/DD)

Player Gender

Lead Contact Full Name

Lead Contact Relationship to Player

Lead Contact Email Address

Lead Contact Phone Number

Secondary Contact Full Name

Secondary Contact Relationship to Player

Secondary Contact Phone Number

Address Line 1

Address Line 2

Town

Post Code

Current School

Detail any injuries, allergies, disabilities, illnesses or relevant health concerns we should know about?

Any Further Supporting Information

I confirm to the best of my knowledge that my son/ daughter does not suffer from any conditions other than those listed above. I confirm to the best of my knowledge that my son/ daughter does not suffer from any conditions other than those listed above. I confirm

I understand that on occasions the club will publish non-sensitive media that may include my son/ daughter on its own social media channels, website and other club related social media channels. I understand that on occasions the club will publish non-sensitive media that may include my son/ daughter on its own social media channels, website and other club related social media channels. I understand

I understand that the Club or Organisers accept no responsibility for loss, damage or injury caused by or during attendance of any of the clubs organised activities except where such loss, damage or injury can be proven to derive directly from the negligence of the Club or the Organisers. I understand that the Club or Organisers accept no responsibility for loss, damage or injury caused by or during attendance of any of the clubs organised activities except where such loss, damage or injury can be proven to derive directly from the negligence of the Club or the Organisers. I understand

I understand that once my player has had their taster session and has been offered a space, that I need to send an initial payment that includes my player's final month in advance. I understand that once my player has had their taster session and has been offered a space, that I need to send an initial payment that includes my player's final month in advance. I confirm

I understand that once my player has had their taster session and has been offered a space, further to my initial payment I will need to set up an automated Standing Order for the 1st of each month. I understand that once my player has had their taster session and has been offered a space, further to my initial payment I will need to set up an automated Standing Order for the 1st of each month. I confirm