SUSSEX COUNTY LTCADULT MEMBERSHIP APPLICATION FORM2019 – 2020 Age 18 and Over Step 1 of 4 25% Membership Category*Senior MemberCouple MembershipFamily MembershipIntermediate MemberCountry MemberLiving at the same address.Please provide both names.Two adults and any number of juniors aged under 18.Please provide the names of spouses/partners and children under the age of 18.Aged 18 to 21 in full-time education.Resident outside Sussex.Membership Fee £ 0.00 Name* First Name Surname Name* First Name Surname Junior Details*Please provide the names and dates of birth of children under the age of 18.NameDate of Birth Email Address* Phone Number*Phone Number (optional)Address* Address Line 1 Address Line 2 City County Post Code British Tennis Membership NumberPlease note that this information may be stored on a computer database and a website run on a server outside the EU and UK. Website Registration*Access to the club website members' area (court booking system, photo gallery, member contacts, news, events, tournaments, and more).YesNoYour name/email address and other optional data are stored on the club website.Please advise at the time a photograph is taken if you do not wish the photograph to be used on the club website.Display Contact Details*Display your contact details on the club website and clubhouse noticeboard.YesNoYour contact details are stored on the club website.British Tennis Membership*Permission for the club to sign you up to free British Tennis Membership Lite.YesNo Membership Fee £ 0.00 Payment Method*Bank TransferCardChequePlease contact the club.Cheque payable to Sussex County LTC with member`s name on the back of the cheque.Credit/Debit Card* MasterCardVisa Card Number Month010203040506070809101112 Year20192020202120222023202420252026202720282029203020312032203320342035203620372038 Expiration Date Security Code Cardholder Name Signature*Date* Date Format: DD slash MM slash YYYY * I wish to apply for membership and, if accepted, I agree to abide by the rules and bye-laws of the club which are posted on the club noticeboard and the club website. I consent to scltc.co.uk collecting and storing my data from this form. Card data is not stored. How did you hear about us?PhoneThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.