Membership Form 1^st May 09 – 30^th April 10

Name of Player ……………………………………………………

Age (as at 1.5.09)……………….. Date of Birth………………….

Address…………………………………………………………….

             ……………………………………………………………

Home Tel No…………………….Emergency No…………………

**E-Mail address………………………………………………….. 

** Only supply this if you wish. It WILL NOT be passed on to any person who is not a club official

Has any medical conditions changed since you last filled in a medical form? YES / NO if yes download and complete a new medical declaration form click hear

Membership Category (please refer to coaches for prices / best suitable)   

click for details

Full junior membership     □

Full club membership       □  

Part membership             □

Please sign the following:

I am happy for my child (named above) / myself to attend the Brigg & district Netball club and have read, understood and accept their codes of conduct (available on the web site).

*I also consent / do not consent for my child / my photo (no names) to appear on the clubs web page – or just their names on match reports. 

* If never is crossed out – we will assume we are able to show photos on the web page.

Signature…………………………………………………

Print Name ………………………………………………

(Parent / guardian if under 18)                  Date………………………… 

AS OF THE 1^ST MAY 09, IF THE MEMBERSHIP HAS NOT BEING PAID – THE CURRENT NONE MEMBERSHIP SESSION / MATCH FEES WILL BE APPLICABLE UNTIL THE MEMBERSHIP FEE IS PAID.

A Local Club For Local Children

© 2006.Brigg and District Netball Club.all rights reserved.