SIDMOUTH CRICKET, TENNIS & CROQUET CLUB SIDMOUTH CROQUET CLUB – NEW MEMBERSHIP

[Please note: Annual subscription fees are non-refundable under any circumstances]

This form is for completion in WORD

On completion ‘save as’ ‘my initials & name’ & email to the Croquet Membership Secretary:

philipharris470@btinternet.com	[Philip Harris, 20 Witheby, Sidmouth EX10 8SR]

Title: Title	Forename: enter forename	Surname: enter surname

Contact Tel enter contact number	Email enter email address.

Title: Title	Forename: enter forename	Surname: enter surname

Contact Tel enter contact number	Email enter email address.

Address 1 enter address – house name / number and street

New Members Subscription Rates	Country Members, i.e. living over 50 miles from the Club, may claim a 50% subscription reduction Click box to claim ☐
Apr	May	Jun	Jul	Aug	Sep	Oct	Nov	Dec	Jan	Feb	Mar
Single	183	183	183	146	146	110	101	92	73	55	37	18
Family	371	371	371	297	297	223	204	186	148	111	74	37
Student	45	45	45	36	36	27	25	23	18	14	9	5

Address 2 enter town & county	Post Code enter postcode

Insert amount paid	£ Enter Amount

Payment Options: Cheques are charged at 40p to pay in. If you can please pay:

Direct to our Club HSBC bank account: Reference: Your surname & Initials

Account: Sidmouth Croquet Club	Sort code:	40-24-28	Account Number:	41467921

Or forward a cheque made payable to: Sidmouth Croquet Club

Please advise payment option used [Click on option]:

I paid direct to the bank	☐ and email my form saved as ‘my initials & name’

I enclose the form	☐	but paid direct to the bank	☐

I completed the form which I & enclose with my cheque	☐ - and posted

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Handicap [If you have one]:	Association: Enter No	Golf Enter No

DATA PROTECTION LEGISLATION – The Croquet Club Membership Secretary maintains a computer list of Croquet Members’ names, addresses, telephone numbers and email addresses for our own internal mailing list. This information is used by Sidmouth Cricket, Tennis and Croquet Club for communication purposes only. Your details will be removed when you cease to be a member. In no circumstances whatsoever will any of the data be passed to any other person, club or company. Club Rules & Privacy Policy are be posted in the Pavilion and on the section website [Quick Link ‘Policy’ tab.]

Please confirm that you agree to the above conditions

Signed enter name here	Date select date.	select

Signed enter name here	Date select date.	select

The Croquet Membership Secretary will issue your membership card. Please always have it available when purchasing drinks in the Club to protect our license with EDDC.

For Croquet Membership Secretary use. Application received on _______________