Membership Application

Title *
First Name *
Last Name *
Address *
City *
Postcode *
Date of birth *
Telephone (Home) *
Previous playing experience
Telephone (Work)
Mobile *
E-mail *
I wish to apply for *	Full Student Junior Occasional Associate
Membership of Deeside Ramblers Hockey Club. I understand that the committee of the Club may accept or reject my application without giving any reason for so doing and that the committee's decision will be final. I undertake, on notification of the acceptance of my application, to pay any unpaid portion of the Club's annual subscription. I acknowledge notification that the club's record are kept on a computer and I do not object to my personal details being so recorded
Proposing Member Name *
Date (dd/mm/yy) *
* Note: Student/Junior/Occasional membership will apply as long as the member qualifies for that description. student membership applies only to those attending university or college. Occasional member will play less than 6 games per season
Verification *

Membership Application