Family Membership Form 2016

* Indicates required field

House name/number *

Address line 1 *

Address line 2 *

Town/city *

Postcode *

Contact details

Please indicate if you agree to share e-mail addresses and telephone numbers with other members, for example to help us match appropriate playing partners

Home telephone number (please include a space after area code) *

Share home telephone number? *

Yes No

Mobile telephone number (please leave a space between codes) *

Share mobile telephone number? *

Yes No

Work telephone number - adult members only (please include a space after area code) *

Share work telephone number *

Yes No

Home email address *

Share home email *

Yes No

Work email *

Share work email *

Yes No

If you have advised us of your email address you will automatically receive updates and news of special events. If you do not wish to receive them please indicate below *

I do not want to receive updates and news of special events

Please indicate your membership period for 2016 *

Player 1

Title *

Name *

First

Last

Status *

Gender *

School (juniors only) *

School year *

Date of birth (day 00, month 00, year 0000) *

Please let us know any relevant medical information that we should be aware of *

Player 2

Title *

Name *

First

Last

Status *

Gender *

School (juniors only) *

School year (juniors only) *

Date of birth (day 00, month 00, year 0000) *

Please let us know any relevant medical information that we should be aware of *

Player 3

Title *

Name *

First

Last

Status *

Gender *

School (juniors only) *

School year (juniors only) *

Date of birth (day 00, month 00, year 0000) *

Please let us know any relevant medical information that we should be aware of *

Player 4

Title *

Name *

First

Last

Status *

Gender *

School (juniors only) *

School year (juniors only) *

Date of birth (day 00, month 00, year 0000) *

Please let us know any relevant medical information that we should be aware of *

Player 5

Title *

Name *

First

Last

Status *

Gender *

School (juniors only) *

School year (juniors only) *

Date of Birth (Day 00, Month 00, Year 0000) *

Please let us know any relevant medical information that we should be aware of *

Agreements

To be completed by a parent or guardian. Please indicate if you have any objections to images being taken at Charlton Kings Tennis Place which may be used for promotional and marketing purposes (for example on the club website). Please note that all personal details will be kept confidential. *

British Tennis Membership
By completing this form we are giving you the opportunity to be signed up as a British Tennis Member for free (a benefit of being a registered Place to Play). This will enable you to take advantage of the many benefits offered to British Tennis Members including Wimbledon tickets, exclusive news, discounts and a player rating. For more information click here.

British Tennis Membership *

For more details about what your consent means click here.

If you agree to be a British Tennis Member, occasionally, the LTA may also use your details to: *

send you information about LTA offers and offers from third parties that the LTA work with by post, email or SMS. Please tick this box if you do not want to hear about these offers. pass your contact details on to carefully selected third parties so that they can send you, by post, details of their products and services. Please tick this box if you do NOT want the LTA to pass on your details