Additional Family member/s form

Existing Members Name:*

Existing Member's membership number:

Existing Member's Address:*

Existing Member's Email Address:*

Subscription payment to be taken from existing direct debit:*

Yes
No
Contact me to discuss

Membership card spending to be linked?:*

Yes
No
Contact me to discuss

Additional Family Member's Name:*

Include preferred title, first and surname

Date of Birth:*

Email Address:*

Telephone number:*

Any additional family members to be added at this time:

Please include name, date of birth and contact details.

Help us to get to know them:

Please share their interests at the Club so we can help them get involved in Club life.

I consent to the Club holding the above-mentioned records: :

I am aware that: Members must accept the Club’s Privacy Statement as published on the Club’s Website and, as detailed in that Statement, provide their permission for the Club to hold, process and, where appropriate, publish certain elements of their personal information which are identified within that Statement. Members will have the right to request that certain elements of their personal information should not be published e.g. home address, but this would be managed on a case-by-case basis

Security code:

Enter security code: