General Application Form

1928 Affiliated to Middlesex County L.T.A.

Greenford Tennis Club

76 RAVENOR PARK ROAD, GREENFORD,MIDDLESEX. UB6 9QY

APPLICATION FOR JUNIORMEMBERSHIP

JUNIOR’S DETAILS: / Male / Female
Please use block LETTERs
First Name
Last Name
Date of Birth / d / d / m / m / y / y / y / y / Ethnic Background (See next page)
Address
Post Code
Mobile
Email *
PARENT/GUARDIAN’S DETAILS:
Phone Home
Phone Office
Mobile
Email *
* I consent to receiving Emails from the Club about news and events etc. YES / NO

Parent/guardian declaration (essential if applicant is under 16 years of age).

By signing and returning this form, I agree to …………………………………. (child’s name)

taking part in the general activities of the club. He/she has agreed to follow the ‘Rules’ of the club, and I agree to accept the ‘Code of practice for parents and guardians’ as displayed in the clubhouse.

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.

Signed: ...... Date: ...... /...... /20......

Name: …………………………………….

Where did you hear about the Club ? ......

Bank Details: - SANTANDER, SORT CODE: 09-01-53 ACCOUNT: 46324300 REFERENCE: GTCSUB

______

For Official UseMembership No: ......

Sub Paid: £...... /...... /20......

Notice to Juniorsissued by:...... /...... /20......

Membership card issued by:...... /...... /20......

Records updated by: ...... /...... /20......

Comments ......

ETHNIC BACKGROUNDS

AB = Asian Bangladeshi.ME = Middle Eastern.

AI = Asian Indian.OA = Other Asian.

AP = Asian Pakistani.OTH = Any other ethnic group.

AS = Asian Sri Lankan.OWE = Other White European.

BA = Black African.WB = White British.

BC = Black Caribbean.WI = White Irish.

BO = Black Other.WO = White Other.

The London Borough of Ealing supports the Club by awarding Discretionary Rates Relief.

The Council has recently requested that we provide them with a breakdown of the ethnic backgrounds of our members, expressed as percentages only. Members personal details are not requested or supplied.