Membership Type

Full Junior/Student Family Off-Peak Trial *

Title (Mr/Mrs/Ms/Miss)

* *

Forename

* *

Surname

* *

Address

* *

Postcode

* *

Phone Number

* *

Email Address

* *

Declaration

* I agree to abide by the Club rules and codes of conduct at all times. I accept that the Club cannot be held responsible for any loss or injury to me, however caused. I have read and understood the Club’s privacy policy♰, and agree to its terms.

Family Membership Only: Please complete the details of additional family members to be included.

Name

*

Phone Number

*

Email Address

*

Name

*

Age

8 9 10 11 12 13 14 15 16+ *

Name

*

Age

8 9 10 11 12 13 14 15 16+ *

Declaration

* I am satisfied that each of my family members will abide by the Club rules and codes of conduct at all times. I accept that the Club cannot be held responsible for any loss or injury to any of them, however caused. I have read and understood the Club’s privacy policy♰, and agree to its terms on their behalf.

Junior Membership Only: To be completed by Parent/Guardian.

Name of Parent/Guardian

* *

Declaration

* I am aware that my son/daughter is applying for membership of Ickleford Squash Club, and am satisfied that he/she will abide by the Club rules and codes of conduct at all times. I accept that the Club cannot be held responsible for any loss or injury to him/her, however caused. I have read and understood the Club’s privacy policy♰, and agree to its terms on their behalf.

Student Membership Only: Please complete the details.

Name of School/College

* *

Declaration

* I confirm that I am in full-time education. Proof will be supplied if requested.