Hackney Tennis
ADULT MEMBERSHIP FORM
Please email to: info@hackneytennis.co.uk
Name
Date of birth
LTA membership
Address
Rating
Postcode
Email
Telephone
Mobile
Tennis Experience – tick all that apply (Only if you are new to the Club)
Complete Beginner
Play socially with friends
Been on coaching courses (please describe)
Been a member at another club (which club?)
Played for a club team (which county and division?)
Played junior county level (which county and at what age?)
Played junior regional or national level (which level and at what age?)
Played adult county level (which county?)
Played adult regional or national level (which level?)
Do you have a disability?
Yes
No
If yes, please give details:
Do you 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 myself 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 me.
Signature
Print name
Office use only
Invoice sent
Added to Outlook contacts
Date:
Welcome letter +T&C sent
Date of payment
Added to database