Download Leisure Centre Membership Application Form
Download Leisure Centre Membership Application Form
Download Leisure Centre Membership Application Form
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Surname<br />
Forename<br />
Address<br />
Occupation<br />
Company<br />
Telephone (Home)<br />
(Work)<br />
email address:<br />
Tick to receive notice of special offers and addtitional information on the hotel’s facilities<br />
Type of <strong>Membership</strong> applied for<br />
Please give the name of all persons to be covered in the membership<br />
Mr/Mrs/Miss<br />
Mr/Mrs/Miss<br />
Mr/Mrs/Miss<br />
Mr/Mrs/Miss<br />
Mr/Mrs/Miss<br />
Date of Birth<br />
Date of Birth<br />
Date of Birth<br />
Date of Birth<br />
Date of Birth<br />
Payment Method: (Please Tick) Cash Cheque Credit Card<br />
Visa/Mastercard/Laser Credit Card No.<br />
Exp Date<br />
Cardholder Signature<br />
Signature<br />
Date
For Office use only<br />
<strong>Membership</strong> ID no.1 no.2 no.3<br />
no.4<br />
no.5<br />
Expiry date<br />
All enquiries to: The <strong>Membership</strong> Secretary
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