Lostwithiel Bowling Club.
Application for Playing Membership
Title (Mr/Mrs/Miss/Ms/Dr/Other) …………………………………..
Forename …………………………………………………………………………
Surname ……………………………………………………………………………
Address ……………………………………………………………………………………………………………………………………………………
Postcode …………………………… ………….
Tel. Number you prefer to be contacted on ……………………………………………………..
Email ………………………………………………………………………………………………………
* You are not obliged to complete the next three questions, only if you wish to do so.
Date of birth …………………………………………………………..
Next of kin Name …………………………………………………………………………………..
Address ……………………………………………………………………………….. tel no. ……………………….
Medical History. Are there any medical conditions that you would be willing to disclose, that the club should be aware of for your own safety and well-being.
………………………………………………………………………………………………………………………………..
Signature ………………………………………………………………………………… Date ………………………………………………
Introduced by ……………………………………………Bowling history (if any) ………………………………………………………
Approved by …………………………………………….. Chairman/Secretary on behalf of the Committee Date ………………….
Please return to the Club Secretary : Penny Philp, Tredour, Lerryn PL22 0PY Tel. 01208 873169
Email penny981@btinternet.com
Please note:
Membership fee: the annual membership fee is decided annually at the club’s AGM, usually held in October. There is a reduced membership fee in the first year of your membership of the club.
Data Protection statement: Your data will be held securely and only used for bowling related activities.