Junior Membership Application Form

Membership Category*
- Junior Member aged 10 and under
- Junior Member aged 11 to 17
Membership Fee
£ 0.00
Name*
First Name Surname
Date of Birth*

DD
MM
YYYY
Parent Name*
First Name Surname

Special Requirements
Please describe any special care needs, dietary requirements, allergies or medical conditions.
British Tennis Membership*
Permission for the club to sign you up to free British Tennis Membership Lite.
- Yes
- No
Please note that this information may be stored on a computer database and a website run on a server outside the EU and UK.
Please advise at the time a photograph is taken if you do not wish the photograph to be used on the club website.

Junior Member's Signature*
Date*
Parent / Guardian Declaration (essential if the applicant is under 16 years of age)*
- I agree to my son/daughter taking part in the general activities of the club. He/she has agreed to follow the junior rules of the club and I agree to accept the code of conduct for parents. To my knowledge, he/she has no special care needs, dietary requirements allergies or medical conditions that could affect his/her safety at the club; other than those declared on this form. I understand that in the event of any injury, illness or other medical need all reasonable steps will be taken to contact me and deal with the situation appropriately. I understand that I must inform the club of any changes to the information provided on this form.
Parent/Guardian Signature*
Date*

Membership Fee
£ 0.00
Payment Method*
- Bank Transfer
- Card
- Cheque
Please contact the club.
Cheque payable to Sussex County LTC with member`s name on the back of the cheque.
Credit/Debit Card*

MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
*
- 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?
Name
This field is for validation purposes and should be left unchanged.