Penlee Park ⋅ Penzance ⋅ Cornwall ⋅ TR18 4HE Tel: 01736 367627 E-mail: info@penzancetennisclub.co.uk www.penzancetennisclub.co.uk JUNIOR MEMBERSHIP RENEWAL FORM st st April 1 2015 to March 31 2016 Subscription Categories (*please tick against appropriate category) Junior 13-16*___ Junior 8-12* ___ Junior U8* ___ The information you provide will be treated securely and used only to promote the safe and efficient operation of Tennis Club activities. As the form is applicable for the entire year, IT IS IMPORTANT THAT YOU TELL US IN WRITING OF ANY CHANGES. By filling in this form, you are also being automatically signed up as a British Tennis member for free (tick opt out section if not wanted). This will enable you to take advantage of the many benefits offered to British Tennis members including Wimbledon tickets, exclusive news and discounts and a player rating. For more information visit www.LTA.org.uk/membership. By giving your consent to your child becoming a British Tennis member, you agree that your child will abide by the Terms and Conditions of British Tennis Membership (at www.LTA.org.uk/BTMTC) and that the LTA and its directly affiliated bodies (see www.LTA.org.uk/affiliatedbodies) can use the personal data of your child, including sensitive personal data that you provide, for the purposes of your involvement in British Tennis and to send you/your child by post, e-mail or SMS information related to those purposes (for more information see www.LTA.org.uk/privacy). I wish to opt my child out of British Tennis Membership _____* (* tick here) Please use a separate form for each child and write clearly Surname First name Male/Female* (*delete) Address: □□□□ □□□ Postcode: Telephone: Mobile: Email (please write clearly!) st Child’s age on January 1 2015 Date of Birth Emergency contact name and tel. no. Emergency contact name and tel. no. Medical notes/special provision/travel sick etc. Please state here and use separate sheet as necessary. 201516 Junior Renewal Form (1) Page 1 of 2 JUNIOR MEMBERSHIP SUBSCRIPTION CHARGES 2015/16 Subscription Category Junior 13-16 Junior 8 – 12 Junior U8 Agreed Increase 2% Total subs if paid before 1/4/2015, based on 2% discount 2015/16 2015/16 (prompt payment) £84 £62 £23 £82 £61 £22.50 Parents/Guardian consent I have read and fully understood the information contained in this form and have provided any additional information that I consider relevant. I undertake to immediately inform the Membership Secretary in writing of any changes to the information provided on this document. I consent to my son/daughter participating in any Tennis Club activity provided. I consent to my child travelling by any form of public, contracted or private transport organised by the Tennis Club, if it is necessary to do so. I consent to first aid and emergency medical treatment being administered to my child if required by suitably qualified personnel. We occasionally use photographic images of tennis club activities, including participants, for promotional and reporting purposes. Such images are carefully vetted before use. I consent to my son/daughter appearing in such photographs. The Tennis Club only provides supervision during organised activity sessions, e.g. coached sessions and the junior club evening. I understand that the Tennis Club’s responsibility commences at the time my child’s organised activity commences and ceases at the time my child’s organised activity ceases. I am aware that it is my responsibility to arrive on time for both delivering and collecting my child from Tennis Club activities. Data Protection We hold names and addresses and basic medical information that you give us in order to safely and efficiently administer Tennis Club activities and to take relevant action in the event of an emergency following Data Protection Act 1998 principles and requirements. We keep this information for up to 12 months. This information will only be made available to appropriate Officers of the Tennis Club and our membership management service provider and we will not share this information with anybody else without your permission. We may use this information to contact you about future Tennis Club activities GIFT AID Do you know that if you are a tax payer you can Gift Aid donations that is any amount over and above subscriptions, to Penzance Tennis Club? As a HMRC registered Community Amateur Sports Club (CASC) the Club will receive an extra 25 pence for every pound you donate under the HMRC Gift Aid Scheme http://www.hmrc.gov.uk/individuals/giving/gift-aid.htm at no extra cost to you! If you are a higher rate tax payer then the Club and you, can benefit by giving. More information, and Gift Aid application forms are available from the office and our website. Cheques made payable to “Penzance Tennis Club” Cheque £_________enclosed Subscriptions are non refundable. Any appeals should be made to the committee in writing. Signed _________________________________________________Date_____________________________________ Print Name ______________________________________________________________________________________ By signing I agree to abide by Club & LTA Rules http://www.lta.org.uk/Footer/about-us/Policies-and-rules/LTA-Rules-and-Regulations Office hours: Monday 1.30-5pm 201516 Junior Renewal Form (1) Tuesday 1-5pm Wednesday 9am-1pm , 1.30-3pm Friday 1-3pm Page 2 of 2
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