OAKLEIGH PARK LAWN TENNIS & SQUASH CLUB

100 OAKLEIGH ROAD NORTH, WHETSTONE N20 9EZ

ANSWERPHONE: (020) 8445 7221

www.oakleighparkclub.co.uk

JUNIOR MEMBERSHIP APPLICATION FORM

FULL NAME:_____________________________________________________________________

ADDRESS:_______________________________________________________________________

Telephone No: _________________Mobile:_____________________Email:_____________________

Date of Birth :

PARENT/GUARDIAN contact details:

Telephone_________________Mobile:_____________________ Email:_____________________

Previous playing experience and Clubs _____________________________________

British Tennis Membership No. (If applicable): LTA Rating (if applicable):

Where did you hear about Oakleigh Park?____________________________________

Please tick the appropriate category of membership below:

SUBSCRIPTIONS as at 1^st MARCH 2009

Type of Membership	Section	Eligibility Age at 1^st March 2009	Membership Fee	Tick
Child	Tennis	Under 14yrs	£65.00
Junior/Student	Tennis	14yrs + in full time education	£75.00
Child	Squash	Under 14 yrs	£55.00
Junior	Squash	14yrs + in full time education	£65.00
Child	Tennis/Squash	Under 14 yrs	£80.00
Junior/Student	Tennis/Squash	14 yrs + in full time education	£90.00
Junior/Student	Tennis/Gym	Over 16yrs in full time education	£135.00
Junior/Student	Squash/Gym	Over 16 yrs in full time education	£125.00
Junior/ Student	Tennis/Squash/Gym	Over 16 yrs in full time education	£150.00

All subscriptions include a returnable £5.00 deposit for a door entry key fob

Students must show proof as full time students. New members joining part way through the year will pay annual subscriptions on a pro rata basis.

No refunds of subscriptions or suspensions of membership will be given for any reason

THE ABOVE FEES ARE VALID UNTIL 1^st MARCH 2010

I agree to abide by the Club’s rules and bye laws. I give permission for my name and phone number to be displayed in the membership list

Signature___________________________________ Date:____________________________________

(parent/guardian to sign if under 16)

SEND THIS APPLICATION AND A CHEQUE MADE PAYABLE TO OPLTSC TOGETHER WITH A SELF ADDRESSED STAMPED ENVELOPE TO

JILL McCLUSKEY, MEMBERSHIP OFFICE, OAKLEIGH PARK TENNIS & SQUASH CLUB 100 OAKLEIGH ROAD NORTH WHETSTONE N20 9EZ

PTO

Parent/guardian declaration (essential if applicant is under 16)

By signing and returning this form, I agree to…………………………………..taking part in the general activities of the club. He/she has agreed to follow the junior rules of the club and I agree to accept the code of conduct for parents.

_________________________________________________________________________________________________________

All applicants over 16 must sign this Child Protection declaration

CHILD PROTECTION DECLARATION FORM

Oakleigh Park Tennis Club aims to create an enjoyable environment for all juniors who wish to take part in tennis, squash and social activities at the Club.

The club emphasises that young people have the right to be safe, secure and free from threat.

The club acknowledges that young people have the right to be treated with respect and for their concerns to be listened to and acted upon

The club will ensure that junior members have specific programmes and facilities designated for them with adequate supervision.

The club has procedures in place to help any young person who requests help and support on a confidential basis in issues relating to Child Protection

The club will ensure that all its coaches have signed the club self declaration form in relation to Child Protection and have had CRB checks.

The club will ensure that any club members and volunteers working with young people are aware of and apply the LTA Code of Conduct for Those Working with Children in Tennis and have signed the club self declaration form in relation to Child Protection.

The Club has an adult member who is specifically responsible for young people.

In applying for membership of Oakleigh Park you are required to declare any pending prosecutions or convictions which relate to young persons or children together with any cautions. This information will be treated in confidence.

Please disclose any such information on the form below. Failure to disclose such criminal convictions may disqualify you from our membership and may render you liable to immediate dismissal without notice.

I/we declare that I/we have no pending prosecutions or convictions which relate to child abuse.

PRINT NAME:…………………………. PRINT NAME……………………..

Signature………………………………… Signature……………………………

Date:……………………………………...