SUSSEX COUNTY LTCJUNIOR MEMBERSHIP APPLICATION FORM2022 – 2023 Age Under 18 Step 1 of 5 20% Membership Fee Type*Pro-rataOfferSPECIAL OFFER: MEMBERSHIP UNTIL 28TH FEBRUARY 2023. OFFER ENDS ON 5TH DECEMBER 2021.WINTER OFFER: MEMBERSHIP UNTIL 28TH FEBRUARY 2023.Membership Category*SPECIAL OFFER: DISCOUNTED FEES FOR 2022-23 ONLYMembership until 28th February 2023.Please note the new age categories for 2022-23.Junior Member aged 12 and underJunior Member aged 13 to 17Membership Category*SPECIAL OFFER: DISCOUNTED FEES FOR 2022-23 ONLYMembership until 28th February 2023.Please note the new age categories for 2022-23.Junior Member aged 12 and underJunior Member aged 13 to 17Membership Category*SPECIAL OFFER: DISCOUNTED FEES FOR 2022-23 ONLYPlease note the new age categories for 2022-23.Junior Member aged 12 and underJunior Member aged 13 to 17RejoiningYou were a member in the 2021-22 membership year. Member (2021-22) Spring Discount10% Discount. Price: £ 0.00 Membership Fee £ 0.00 Name* First Name Surname Date of Birth* DD MM YYYY Gender*MaleFemaleParent Name* First Name Surname Email Address* Phone Number*Phone Number (optional)Address* Address Line 1 Address Line 2 City County Post Code British Tennis Membership Number Special RequirementsPlease 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.YesNoPlease 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* Date Format: DD slash MM slash YYYY 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* Date Format: DD slash MM slash YYYY Promotional Discount CodePromotional Discount Price: £ 0.00 20% Discount.Membership Fee £ 0.00 Payment Method*Bank TransferBank transfer to Sussex County LTC - 30-91-91 - 30880360, reference: junior member`s name.Please pay when this form is submitted.Cheque payable to Sussex County LTC with junior member`s name on the back of the cheque.Credit/Debit Card* Card Details 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?CommentsThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.
