Boughey Gardens Tennis Club Membership application/renewal form 2015 2015 Season 1st April 2015 to 31st March 2016 Rates for full year: Adult £115.00, Couples living at same address £190.00, University Student £50.00, Junior (12-18) £30.00, Under 12 £15.00 Family £240.00 (2 Adults and up to 3 Children under 18) Early Payment discount of £10.00 for Full Adult Couples and families if paid before 30 th April 2015 One form should be completed for each membership or family member. Please return your completed form and payment to a member of the committee or send by post to Club Membership Secretary, Carlton Adams, 17 Islington Close, Newport, Shropshire, TF10 7TT. Tel: 01952 812257. Email: [email protected] Name (please print) Gender Date of birth: Male / Female (delete as appropriate) Address Contact numbers: Home Mobile Email address Membership Type Adult Couple Student Family 12-18 5-12 British Tennis Membership No * *If you are not a British Tennis Member it is the Club’s policy to register all members for British Tennis Membership. If you DO NOT want to be registered as a free BT Member, please tick the box. Amount enclosed: £________ Please make Cheques payable to Boughey Gardens Tennis Club. If you prefer to pay by bank transfer our bank details are; Branch Lloyds Newport, Sort Code 30-96-02, Acc No 00624799 Signed: _______________________________ Date: _______________ The Information given on this form is for Boughey Garden’s official use only and will be handled in the strictest confidence.