Rishworth Sports Club Application Form 2010
Title ______
First Name(s) ___________________ Surname_________________ Sex __
Address ___________________ DOB _______________________
___________________
___________________ Tel __________________________
___________________ Mob _________________________
Post Code ___________________ Email __________________________
Family Associate Member Name (Including Membership Category)
Partner Associate Member Name 2_______________________
2_______________________
3_______________________ 5_______________________
4_______________________ 6_______________________
Office Use Only
|
Membership |
Junior |
Adult |
Partner |
Family |
|
Racquet |
|
£60 |
|
|
|
Swim |
£30 |
£145 |
£220 |
£275 |
|
Gym |
£70 |
£220 |
£375 |
£500 |
|
Club |
£80 |
£300 |
£490 |
£600 |
| Off Peak Gym |
£55 |
£165 |
£300 |
£440 |
| Off Peak Club | £60 | £265 | £425 | £540 |
Membership No’s Payment Type
1) __________
2) __________ Cash / Cheque / Credit Card / Debit Card
3) __________ / Direct Debit
4) __________
5) __________
6) __________ Amount £_________