Name
Address
Post Code
Telephone Home Mobile
Email address
The Club’s preferred method of communication
May we include your phone number(s) in the list we distribute to members? Yes / No
May we include your email address in the list we distribute to members? Yes / No
Signed: Date:
Full Adult Membership
Introductory membership + 6 group coaching lessons*
£160
£175
£65 Full Time Student (attach copy of Student ID Card)
Winter rate (valid from 1 October 2015) £70
Winter student rate (valid from 1 October 2015) £25
* Introductory membership available in first year only. Six group coaching lessons to be completed during this season.
All memberships run to 31 March 2016.
LEASE EMAIL YOUR COMPLETED FORM TO Steve Blow, Membership Secretary at stephenblow@talktalk.net confirming you have paid your Membership Fee by Bank Transfer (BACS) to the following account - Account Name: ST COLUMBA ’S LAWN TENNIS CLUB, Account No:
92305275, Sort Code: 40-02-26 & Unique Reference: " YOUR SURNAME STC FEES".
Flyer Internet search A406 sign Church

Friend Open Day LTA website Coach
Other (please tell us)
One of the benefits of joining St. Columba’s Tennis Club is FREE membership of British Tennis. British Tennis membership allows you to enter the club’s ballot for Wimbledon tickets each year.
Please ensure that you sign up with British Tennis immediately upon receipt of your confirmed membership application by going to www.lta.org.uk
and follow the link to “ Sign up for British Tennis Membership”.
The committee reserves the right to refuse applications for membership 30 March 2015

Name
Date of Birth
Parent's Name
Address
Gender M / F
Post Code
Telephone
Email address
(for BCC only use)
Home Mobile
The Club’s preferred method of communication
Signed:
Date:
Junior 8-17 yrs (on 1 April 2015)*
£25
£25 Under-8 (on 1 April 2015)*
Under-8 (on 1 April 2015) with full Adult member parent* FREE
Administrative membership for non-playing parent* £15
* Unless a parent of the Junior or Under-8 is a full Adult member, a non-playing Administrative membership is required in addition to the Junior / Under-8 membership. Administrative membership allows parents of Under-8s to play with their child.
All memberships run to 31 March 2016.

Please use this box to tell us about any special needs, allergies, medical conditions etc :
By signing and returning this form, I agree to __________________________________________ (child’s name) taking part in the general activities of the St Columba's Lawn Tennis Club. S/he has agreed to follow the Junior
Rules of the Club, and I agree to accept the Code of Conduct for Parents.
To my knowledge, s/he has no special care needs, dietary requirements, allergies or medical conditions that could affect his/her safety at the club - other than those declared above. I understand that in the event of any injury, illness or other medical need, all reasonable steps will be taken to contact me, and to deal with the situation appropriately.
I understand that I must inform the Club of any changes to the information provided on this form.
In case of emergency, please ensure Parent details are completed in full overleaf and in B
LOCK
C
APITALS
.
We would be grateful if you could also complete the "Where did you hear about us" section.
Signature of Parent ______________________________________________________ Date __________
LTA Child Protection - www.LTA.org.uk/childprotection
Tel : 020 8487 7008/7116 Mobile (24 hour) : 07971 141 024 Email : childprotection@lta.org.uk