MEMBERSHIP APPLICATION FORM 1st April 2018 – 31st March 2019
Family Surname: / Tel No: / Postcode
Address
TYPE OF MEMBERSHIP /

Family Discounts : Minimum of 1 Full or Midweek Adult plus 1 Paying Junior : 10% off the total amount

OR Flat Rate of £470
1 = Full Adult Member / £220 / 5 = Junior aged under 5 at 01/04/2018 / £15
2 = Midweek Adult Member / £160 / 6 = Under 26 / £75
3 = Junior aged 11-18 at 01/04/2018 / £75 / 7 = Associate Member (non-playing) / £25
4 = Junior aged 5-10 at 01/04/2018 / £60 / 8 = Table Tennis Member / £30

NB Subscriptions can be made in two equal instalments with the 2nd cheque post dated to 01/07/18 (This disallows prompt payment discount)

Any member attending the club who has not renewed by 01/05/2018 risks having his/her key fob cancelled with loss of deposit

APPLICANT DETAILS
Forename / Surname / Email address / Date of Birth / Sex M/F / Membership
Type Code / Current Member Y/N / PAYMENT £
Please make cheques payable to
Carshalton Lawn Tennis Club
Or: by bank transfer
Name of account: The Carshalton Lawn Tennis Club
Sort code: 20:84:17 Account No: 50243191
/ Bank Transfer Reference:
Your Postcode + Surname (max 16 letters)
e.g. Paul Johnson living in SM5 2AB
reference = SM52ABJOHNSON / Total Amount / £
Family Discount - 10% (if applicable) / -£
Total Subscription due after discounts or Family Flat Rate / £

If you consider that you have a disability covered by the Disability Discrimination Act please supply brief details so that we can consider how best to assist you, should the need arise

If you have any queries concerning the completion of this form, types of membership available or the fees payable please email Lynne O’Brien .
Please return this form with the correct remittance to Lynne O’Brien, CLTC Membership Secretary, CLTC, Beeches Avenue, Carshalton Beeches, Surrey SM5 3LW.

A list of members’ names and telephone numbers is displayed in the clubhouse. If you wish your telephone number to be EXCLUDED from this list, please tick this box £

Photographs of members, taken at the club, may be published in local newspapers, leaflets or advertisements, in our newsletter or on our website. If you DO NOT WISH any photographs of you or your family members to be used in this way, please tick this box £