Rishworth Sports Club Application Form 2012

 

Title                  ______             Membership Info     Home

 

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

£65

Swim

£35

£150

£230

£285

Gym

£75

£230

£385

£520

Club

£85

£310

£500

£620

Off Peak Gym

£60

£170

£310

£455

Off Peak Club £70 £265 £440 £555

 

 

 

 

 

 

 

 

 

 

 

 

 

                                     Membership No’s        Payment Type

                                    1) __________                 

                                    2) __________              Cash / Cheque / Credit Card / Debit Card              

                                    3) __________                / Direct Debit

                                    4) __________

                                    5) __________                                         

                                    6) __________               Amount £_________