SUSSEX COUNTY LTCADULT MEMBERSHIP APPLICATION FORM2021 – 2022 Age 18 and Over Step 1 of 4 25% Membership Fee Type*Pro-rataOfferSPECIAL OFFER: MEMBERSHIP UNTIL 28TH FEBRUARY 2022. FEE INCLUDES £10 DISCOUNT. OFFER ENDS ON 6TH DECEMBER 2020.WINTER OFFER: MEMBERSHIP UNTIL 28TH FEBRUARY 2021. FEE INCLUDES £10 DISCOUNT.SPECIAL OFFER: MEMBERSHIP UNTIL 28TH FEBRUARY 2022. OFFER ENDS ON 6TH DECEMBER 2020.WINTER OFFER: MEMBERSHIP UNTIL 28TH FEBRUARY 2021.Membership Category*Membership until 28th February 2022.Senior MemberFamily MembershipIntermediate MemberCountry MemberMembership Category*Membership until 28th February 2022.Senior MemberIntermediate MemberCountry MemberMembership Category*Senior MemberFamily MembershipIntermediate MemberCountry MemberMembership Category*Senior MemberIntermediate MemberCountry MemberTwo 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.CouplesLiving at the same address. Please provide both names. Couple Discount Couple Discount10% Discount. Price: £ 0.00 Club Opening Discount10% Discount. Price: £ 0.00 Spring Discount10% Discount. Price: £ 0.00 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.Name and Date of Birth Email Address* Email Address (optional) 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 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 clubhouse noticeboard and in the members' area of the club website.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.YesNo Promotional Discount CodePromotional Discount Price: £ 0.00 20% Discount.Membership Fee £ 0.00 Payment Method*Bank TransferCardBank transfer to Sussex County LTC - 30-91-91 - 30880360, reference: member`s name.Please pay when this form is submitted.Cheque payable to Sussex County LTC with member`s name on the back of the cheque.Credit/Debit Card* Card Details Cardholder Name Credit/Debit Card* MasterCardVisa Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 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?EmailThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.