The Hull & East Riding Squash Club

President: I. G. Davis
Chairman: A Berriman
Hon. Sec:  G. Moverley
Hon.Treas:  P Webb

Squash Coach: A Cockerill
Telephone 01482 446701		 Chanterlands Avenue North.
Hull.
East Yorkshire.
HU5 4ED
Telephone 01482 446701
E-mail: info@hersquash.co.uk

ANNUAL MEMBERSHIP APPLICATION FORM
September 1st 2009 to August 31st 2010

Name ..........................................................................................................

Tel. No. .........................................................

Address ..............................................................................................................................................

Post code .........................................................E-mail Address...........................................................
Type of Membership. (tick) Annual Subscription
Family Membership.
   (2 Adults + Children under 18 yrs free)		 (   ) £180 plus £4 per child England Squash fee( includes 2 x £15 Sports club fee)
Adult Membership

 (   ) £90 (includes £15 Sports club fee and £6 England Squash fee)*
Student Membership
   (Must be in full time education)		 (   ) £66 (includes £15 Sports club fee and £6 England Squash fee)

Junior Membership
(Under 18 yrs on Sept. 1st 2010)
   Date of Birth ....................
Junior Membership
(Under 14 yrs on September 1st 2010)
Date of Birth........................

(   )

 

( ..)

£32 (includes £4 England Squash fee)

 

£20 (includes £4 England Squash fee)


* Please note : Hull & East Riding Sports Club fee for over 60’s is £7.50.


For the purposes of the Data Protection Act 1984 I hereby confirm that I do not object to the club holding personal data (as above) relating to myself.
I also give my permission for this information to be given to England Squash & Racketball as required under new affiliation rules.

 


Applicants Signature........................................................



The completed form should be forwarded to the Club Treasurer, care of the Club , together with the appropriate membership fee. If Family Membership please include names and date of birth of children .

Cheques should be made payable to the “Hull & East Riding Squash Club“.

Please complete all details so that our records are up to date.