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Boldon Lawn Tennis Club
2015 Membership Application Form
Section One
To be completed by the main applicant.
Please complete the form below and return it to me with the appropriate fees.
Cheques to be made payable to 'Boldon Lawn Tennis Club' and send to the following
address:
Linda Walker
69 Sunderland Road
South Shields
Tyne & Wear
NE34 6LY
Tel: 0191 4233881 or 07860 478332
All personal information you give us will be dealt with on a 'need to know' basis. Any
information shared between committee members, coaches, team captains etc. is
carried out in a manner that keeps your information secure in accordance with the
Data Protection Act (1998).
Full Name:
Membership Category:
Date of Birth (if under 18):
Age category (Over 18)
18-30
31-44
45-60
Over 61
Address:
Postcode:
Telephone:
Mobile:
Email Address:
If you provide an email address, we will send regular updates and notifications to it unless you
tick the box below as it's much more efficient and cost effective for us to communicate with
our members via email. We will never share your email address with third parties or
send SPAM.
New members only: How did you hear about Boldon Lawn Tennis Club?
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Section Two
To be completed by the parent or guardian of Colt/Junior/Mini Tennis applicants (18
and under)
Please use the box below to describe any special care needs, dietary requirements, allergies
or medical conditions for all juniors applying.
By signing and returning this form, I agree to the colt/junior applicants on this form taking
part in the general activities of the club. He/she/they have agreed to follow the rules of the
club, and I agree to accept the code of conduct for parents/guardians.
To my knowledge, he/she/they have no special care needs, dietary requirements, allergies or
medical conditions that could affect their 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 to deal with the situation appropriately. I also
understand that I must inform the club of any changes to the information provided on this
form.
I understand that as a parent, if I am involved in transporting juniors to and from any league
matches, I will ensure that I have read and understood the relevant guidance and that I have
appropriate car insurance.
Please indicate below if you are happy for your child to be included in any photography we
may use as part of the clubs ongoing marketing efforts.
Signature:
Date:
Section Three
To be completed by the parent or guardian of Mini applicants (10 and under)
For their own safety, mini members are not permitted to play at the club unattended. If this
application includes any minis there must also be an adult club member to act as their
guardian whilst they play (unless attending coaching or other club organised sessions).
Please provide details of the nominated guardian member below.
Type:
Name:
Membership Status:
Membership Category:
Address (if different):
Postcode (if different):
Emergency Contact No:
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Section Four
Please show the details of other family members who are joining. Family discount can only be
applied if at least one person joins as a Full fee paying adult member. It cannot be applied
if the adult joins as a Guardian, Off Peak or Social member.
Membership
Category
Member Name
Date of Birth
(Colts & Juniors)
Fee
£
£
£
£
£
£
Total Fees
£
Membership Fees (in pounds sterling)
Membership
Category
Late payment fees will be enforced for
current members paying after 1.4.15
New and Current Members
Family Members
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Discount
0%
5%
10%
15%
Adult Membership Groups
Full
£170
£162
£154
£146
£196
Full Concessionary
£120 (yr 1)
£136 (yr 2
£153 (yr 3
£114
£129
£145
-
-
£156
£176
Off Peak
£110
£105
£100
£95
£127
Student/Assisted
£85
£80
£76
£72
£98
Junior Membership Groups
Colt
£61
£58
£55
£52
-
Junior
£44
£42
£40
£38
-
Mini
£26
£26
£26
£26
-
Other Membership Groups
Guardian
£26
£26
£26
£26
-
Social (nonplaying)
£5
£5
£5
£5
-
Refer to separate sheet for a full explanation of the membership categories.
Notes



Late payment fees apply to existing members who do not renew their membership before 1 April 2015 and not
to new members who join after 1 April 2015.
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A member’s age is based on how old they are on 1 January 2015
Family discount can only be applied if at least one person joins as a Full fee paying adult member. It cannot
be applied if the adult joins as a Guardian, Off Peak or Social member.
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