LONGTHORPE LAWN TENNIS CLUB
MEMBERSHIP APPLICATION / RENEWAL FORM 2012-2013 SEASON
Chairman
Jim Daintith
Tel 01733 890390
Secretary
Anita Leedham
Tel 01733 262543
Names
Date of
Match Play
Birth
Yes / no
(Juniors)
Note 2
Note 1
Treasurer
Liz Norfolk
Tel 01733 269296
Subscription
Notes 3-6
Joining Fee
A/c ref
New Members (Official
Note 7
use only)
1 ___________________________ _______ _____
£_________
£________
______
2 ___________________________ _______ _____
£_________
£________
______
3 ___________________________ _______ _____
£_________
£________
______
4 ___________________________ _______ _____
£_________
£________
______
£
£
Totals
Total amount to be paid £_____________ Cheque / Cash
( Cheques made payable to Longthorpe Tennis Club)
Address
___________________________________________________________________
_____________________________________________________Postal Code_____________
Tel Nos.
Hm: ___________________ Mob:___________________ Wk: _______________
Email: _________________________________
Junior member’s e-mail:___________________________________
Junior Member’s Parent/Guardian’s e-mail: _________________________________________
If you do not wish to have your name and contact details on a list inside the Clubroom please tick this box
Signature ____________________________________
Date _________________
The completed form and fees payable should be forwarded to the Membership Secretary :Ruth Swann (Tel: 01733 266594) raswann@hotmail.co.uk
3 Spinney Walk, Longthorpe, Peterborough PE3 9NR.
Note 1
Note 2
Note 3
Note 4
Note 5
Note 6
The Club requires a signed ‘Parental Consent Form’ for all Junior Members.
[This is available on the website: www.longthorpelawntennisclub.co.uk ]
Please add on form above tick if you wish to be considered for team selection for matches.
(If you wish to add any personal stipulation for selection do so on the reverse of this form.)
Subscription fees for the year 30th April to 30th April 2012 -2013
Adults
£150.00
Junior
£69.00 (Year 5 and above and under 18 yrs. on 1st May)
Student
£69.00 (those in full-time education)
Country Membership £69.00 (those living over 60 miles away)
‘Senior’ Membership £99.00 (those over 70 on 1st May)
Mini Tennis junior
£15.00
Note 7
New Member Joining Fee for 1st season:
Adults
£10.00
Junior/Student
£5.00
NB
Membership takes immediate effect once payment has been sent in.
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Please tick box if adding notes to the other side of this page.