Rishworth Sports Club Application Form

 

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

 

£50

 

 

Swim

£25

£135

£200

£250

Gym

£60

£200

£350

£450

Club

£70

£280

£450

£550

Off Peak Gym

£45

£150

£280

£400

Off Peak Club £50 £240 £400 £500

 

 

 

 

 

 

 

 

 

 

 

 

 

                                     Membership No’s        Payment Type

                                    1) __________                 

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

                                    3) __________                / Direct Debit

                                    4) __________

                                    5) __________                                         

                                    6) __________               Amount £_________