NUNEATON& BEDWORTH SWIMMING CLUB

APPLICATION FOR MEMBERSHIP

PERSONAL DETAILS

Please complete in Block Capitals:

NAME OF PROPOSED MEMBER

DATE OF BIRTH ______MALE/FEMALE ______

ADDRESS

______

POSTCODETEL NO

Email address: ______

DO YOU BELONG TO ANY OTHER SWIMMING CLUB?YES/NO

If YES, name of Club and ASA number: ______

MEDICAL DETAILS

Please state any relevant medical and disability information that the Club and Coaches should be aware of (eg Asthma, Allergies, Medication) and may affect your training. If none, please write NONE.

______

Contact details in the event of an emergency:

First contact name and number: ______

Second contact name and number: ______

SIGNED: ______DATE:______

(Parent/Guardian if applicant is under 18 years of age)

PRINT NAME ______

We will exercise our right as a Community Amateur Sports Club to refuse or revoke membership on non-discriminatory grounds where the membership or continued membership of a person would be likely to be contrary to the best interests of the sport or the good conduct and interests of the Club. Serious infringements may be subject to legal action.

If your child(ren) are absent without explanation and fees are not paid for one month they will be automatically taken off the register.

We respectfully remind parents that photography is not permitted during any of the Club’s training sessions or galas. The Club may occasionally take photographs. Unless otherwise notified my permission is given for the above child to be photographed by the Club.

Data Protection: All data collected on this membership form will be kept securely by club personnel and medical/disability information will be provided to teachers/coaches on a need to know basis. If at any time any of the above details change please contact the membership secretary.

All swimmers have to be affiliated to the ASA (Amateur Swimming Association) in order to compete. The information overleaf is sent to them. In addition the following information is requested:

Country of Representation (England, Scotland, Wales, Ireland, Other) – please tick

Ethnicity (optional) ______

Website Visibility:

If you do not want details of your achievements to be visible on the British Swimming Website please tick here

Caution if you hide your details they will not be visible on the Rankings Database which may affect your ability to enter events. Event organisers may in these cases require proof of age and/or eligibility to enter and you should contct the particular organizer to check.

Offers & Opportunities:

No thank you, I don’t want British Swimming/the ASA to send me details of products and services

No thank you, I don’t want British Swimming/the ASA to send me details of events

No thank you, I don’t want British Swimming/the ASA to send me details from their commercial partners