Kingston Fencing Club
Junior Beginners Fencing Course Application Form 2012
Tuesday Nights (except Xmas & New Year)
Juniors : 6.30 pm to 8.00 pm - Adults : 7.30 pm to 9.45 pm
Web : http://www.kingstonfencing.co.uk
| Parent or Guardian |
Parent / Guardian (delete as applicable) |
|---|---|
| Title |
Mr / Mrs / Ms / Dr (delete as applicable) |
| Forename |
|
| Surname |
|
| Child's Name |
|
| Child's Gender |
Male / Female (delete as applicable) |
| Child's Date of Birth |
Day Month Year |
| Child's Current Age |
|
| Child's Handedness |
Left-Handed / Right-Handed (delete as applicable) |
| Address |
|
| Post Code |
|
| Phone (day time) |
|
| Phone (evening) |
|
|
|
|
| Medical conditions of which we should be aware |
|
| How did you hear about us ? |
|
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.
- For the purposes of Data Protection, personal details of applicants are not disclosed to any third party.
Declaration / Consent (to be signed by Parent or Guardian)
I have read and understood the above information and agree to abide by the Constitution and Rules of Kingston Fencing Club.
| Signature of Parent or Guardian |
|
|---|---|
| Date |
|
Please complete all pages of this enrolment application form and send it with your payment of £45.00 (cheque or postal order payable to Kingston Fencing Club) to Mr Joe Shackell, 10 Lyncroft Gardens, Ewell Village, Surrey KT17 1UR. Applications will be accepted in strict order of receipt of both completed form and payment.