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Application No._____________
Date of Acceptance __________ APPLICATION FOR MEMBERSHIP (Please print and complete both sections) DATE ..
Dear CLUB SECRETARY, I hereby apply for swimming/associate membership of BURNTISLAND A.S.C. for my child/myself. I understand that I will be informed if and when a place becomes available. I also understand that all members on joining the Club shall be deemed to accept the terms of the constitution and any such Byelaws as may be published.
NAME SWIMMER/NON-SWIMMER/ASSOCIATE (please delete as appropriate)
Address .. Date of birth .
.
Post Code .. Telephone no. .. Mobile No .. E-mail address
PLEASE INDICATE IN CONFIDENCE, WITH RESPECT TO YOUR CHILD, ANY MEDICAL CONDITION OF WHICH THE COMMITTEE SHOULD BE AWARE.
Yours sincerely
(Parent/Guardian/Applicant)
BURNTISLAND ASC FOR OFFICAL USE App. No
NAME SWIMMER/NON-SWIMMER/ASSOCIATE
Address Date of Birth
Post Code Telephone No .. Mobile No E-mail address .
PLEASE INDICATE IN CONFIDENCE, WITH RESPECT TO YOUR CHILD, ANY MEDICAL CONDITION OF WHICH THE COMMITTEE SHOULD BE AWARE.
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