Hackney City Tennis Clubs
JUNIOR MEMBERSHIP FORM
Please email to: info@hackneytennis.co.uk
Date of birth
Name
Address
Post code
Address
Email
School
Name of parent/carer
Mobile
Telephone
Emergency contact Telephone
Rating
BTM number
The following sections need only be completed once:
Does your child have a disability?
Yes
No
If yes, please give details:
Does your child have any specific medical problems requiring medical treatment and/or
medication?
If yes, please give details:
Please indicate your ethnicity
Yes
No
White
Mixed
Asian / Asian British
Black / Black British
Other
British
Irish
Other
White & Black Caribbean
White & Black African
White & Asian
Indian
Pakistani
Bangladeshi
Caribbean
African
Other
Chinese
Turkish/Kurdish
Other
Photographs: I acknowledge that certain activities may involve my child being photographed or filmed purely for archive or
promotional use and, therefore, agree to contact the Tennis Office should I disagree.
Communications: Please tick the box if you do NOT wish to receive information about courses/events.
Data protection:
I give my consent for HT to record and store personal information about myself and/or my child
Signature (consent of parent/carer)
Date
Print name
Office use only
Invoice sent
Added to Outlook contacts
Welcome letter +T&C sent
Date of payment
Added to database