Juniors Beginners' Course Application Form 2010
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Parent / Guardian
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Title
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Forename
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Surname
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Child Name
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Address
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Post Code
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………………………………………………………………………………
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Phone (day time)
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Phone (evening)
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E-mail
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Any medical conditions of which we should be aware ?
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YES / NO (delete as applicable)
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If so, please give details
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………………………………………………………………………………
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How did you hear about us ?
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Please complete both pages of this enrolment application form
and submit it with your payment to:
Mr Joe Shackell
10 Lyncroft Gardens
Ewell Village
Surrey KT17 1UR
Applications will be accepted in strict order of receipt of the form
with payment.
Payment
Please enclose a payment of £60.00 for the junior beginner course fee. Cheques should be made payable to Kingston Fencing Club (unfortunately
credit/debit card payments are not possible).
Please supply the following information about yourself to help us in
providing suitable equipment (delete where applicable) :
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Gender
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male / female
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Hand
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left-handed / right handed
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Date of Birth
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Terms & Conditions
- Temporary membership of Kingston Fencing Club will be conferred on
those enrolled on any course organised by Kingston Fencing Club.
- Neither Kingston Fencing Club, its coaches, instructors nor members
shall, in any circumstances whatsoever, be under any liability to the
applicant for any loss, damage or injury (including death), whether
accidental or otherwise, arising during, or resulting from participation
in fencing activities within the Kingston Fencing Club premises or
on the Club's behalf.
- Payment of any subscription or course enrolment fee to Kingston Fencing Club shall constitute an acceptance of all articles of its Constitution,
a copy of which is obtainable from the Secretary.
Data Protection
Personal details of applicants are not disclosed to any third party.
Declaration / Consent (to be signed by Parent / Guardian)
I have read and understood the above information and agree to abide by
the Constitution and Rules of Kingston Fencing Club.
Signature …………………………………….
Date …………………..
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