Adult Membership Form (Annual)

Adult Membership Form (annual)

PersonalDetails

Title: Mr Mrs Miss Ms Full Name:

Date of birth: ______

Gender (Circle your choice): FemaleMalePrefer not answer

Address:

Post code:

Home telephone: Mobile: ____

Email: ______

Which of the follow best describes your ethnic group? (Circle your choice)

White British White Other Mixed Asian/ Asian British Black/ Black British Other:______Prefer not to say

MembershipDetails

BBS Membership No. (for renewals only): ____

Visual impairment status (Circle your choice):

Totally blind Partially sighted Fully sighted

Membership Terms and Conditions

By becoming a member of British Blind Sport:

[ ] I agree for the charity to hold my membership and classification information in line with General Data Protection Regulations (2018).

[ ] I accept that information regarding my membership and classification will be shared with a Sports Sections, National Governing Bodies of Sport and the staff of British Blind Sport when appropriate.

[ ] By becoming a British Blind Sport Member I agree to abide by the BBS Code of Conduct. A copy of this document can be found at

I can confirm that all details provided are correct.

Signed:______Date:______

Payment Details

[ ] I enclose my cheque for £18.00 for full membership

Please send the completed form and cheque (if applicable) to: British Blind Sport, Pure Offices, Plato Close, Tachbrook Park, Leamington Spa, CV34 6WE

[ ] I will make a BACS Payment to British Blind Sport

Acc name: British Blind Sport

Acc no: 7241 7111

Sort Code: 40 27 06

Gift Aid

Please note that £8 of your membership covers the charity’s basic administration cost and the remaining £10 towards your personal benefits e.g. free classification and magazine. As a charitable organisation, BBS can claim 25% Gift Aid from the admin costs if you are a UK taxpayer. This is not an additional cost to you. If you would like to provide Gift Aid to the charity. Please complete the details below.

I am a UK taxpayer[ ] Please tick

My name and address is included within this form.

I am happy for British Blind Sport to claim Gift Aid.[ ] Please tick

Signed: Date:

I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for each tax year that is at least equal to the amount of tax that all the charities or Community Amateur Sports Clubs (CASCs) that I donate to will reclaim on my gifts for that tax year. I understand that other taxes such as VAT and Council Tax do not qualify. I understand the charity will reclaim 25p of tax on every £1.

Please note: BBS membership is not confirmed until receipt of your membership card. If your application is not accepted your membership fee will be refunded

Marketing Preference

From time to time we may wish to contact you regarding your membership, upcoming events or charity news. In line with General Data Protection Regulations (GDPR, 2018) please let us know how you wish to be contacted:

I agree for British Blind sport to contact me regarding any upcoming events or activities within the charity (Circle your choice).

PostEmail Telephone I do not want to be contacted

One of the benefits of your British Blind Sport Membership is a monthly e-newsletter. Do you wish to receive this? (Circle your choice)

YesNo

One of the benefits of your British Blind Sport Membership is the biannual VIsion magazine.Do you wish to receive this? (Circle your choice)

Print copyEmail (Word Doc) Email (PDF)

Audio CDDo not send a magazine

Sport and Physical Activity

What sports do you participate in?

______

Are you a member of a BBS Sports Section, if so which one:

______

Are you a member of any sports club or organisation, if so please name them:

______

Please send the completed form to: British Blind Sport, Pure Offices, Plato Close, Tachbrook Park, Leamington Spa, CV34 6WE. Should you have any questions at all please contact British Blind Sport on 01926 424 247 or email

All information disclosed is protected in line with General Data Protection Regulations 2018. Your personal details will be held on a secure database and will not be shared with any other organisations without your permission. If you register to participate in a BBS-organised sports event, we may need to provide your details to relevant BBS sports section committees and/or relevant BBS partners for administration.