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Membership and match fee early payment. Must be paid by Sunday 1st May to qualify for this discount. *
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Please tell us a little bit about yourself
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Please provide your name
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Please provide your date of birth
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Please provide your mobile number
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Please provide your contact email address
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Add the name of your sponsor organisation for this season.
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2nd sponsor details
Tick the box to add a 2nd sponsor.
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Add the name of your SECOND sponsor organisation for this season. This applies a 100% discount to your membership fee.
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Once you submit your form the next page won't ask for payment details.
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We may need to contact you or another responsible adult in an emergency; we may also need to seek medical assistance, so please CAREFULLY complete the details below...
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Please provide the Name of someone who can be contacted in the unlikely event of an Emergency and if the main parent or carer is unavailable
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e.g. Wife, husband, parent, family friend, other relative, etc.
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Please provide the Landline or Mobile Telephone Number of an Emergency Contact
IMPORTANT: this should be a number on which we can almost certainly reach them in the unlikely event of an emergency.
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Please provide the name of the usual doctor of the applicant
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Please provide the name of the doctor's surgery normally used by the applicant. This should be the surgery at which the doctor named above is based
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Please provide the telephone number of the doctor's surgery detailed above
Please note that you should provide both area code and telephone number, separated by a space
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Please provide details of any recognised disability(ies) or medical conditions that affect the applicant.
If none, please enter N/ A
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Almost finished, just the formalities to complete...
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I understand this is a legal representation of my signature.
Clear
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I have read & agreed the T&Cs *
Please tick this box to confirm that you / the applicant have read and agreed to the relevant and applicable Terms & Conditions, Codes of Conduct and Rules
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