Adult beginners membership form
Analyse sectorielle : Adult beginners membership form. Rechercher de 53 000+ Dissertation Gratuites et MémoiresPar Tzameti • 2 Mai 2017 • Analyse sectorielle • 461 Mots (2 Pages) • 992 Vues
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Adult Beginners Membership Form
We are very pleased to welcome you to Camden Fencing Club
To ensure we have the correct contact details for you, please fill out this form
and email it back to Patricia Aiyenuro. We will also use this information to ensure that you are kept informed about club events.
Name[pic 2]
Address[pic 3]
Postcode
Home telephone number[pic 4]
Mobile*[pic 5]
Email Address[pic 6]
Medical information
Please detail below any important medical information that our coaches/ Junior Coordinator should be aware of (e.g. epilepsy, asthma, diabetes etc.)[pic 7]
Emergency contact details
Please insert the information below to indicate the person(s) who should be contacted in event of an incident/accident.
Emergency contact number[pic 8]
Disability
The Disability Discrimination Act 1995 defines a disabled person as anyone with ‘a physical or mental impairment, which has a substantial long-term adverse effect on his or her ability to carry out normal day-to-day activities’.
Do you consider yourself to have a disability? Yes No
If yes, what is the nature of your disability?[pic 9]
Please detail below any important medical information that our coaches/junior coordinator should be aware of
Visual impairment Hearing impairment Physical disability Learning disability Multiple disability Other (please specify)[pic 10]
PREFERRED COURSE[S]
(A) Beginners Sabre Course
Wednesday 7.00-8.20pm (£100 – six weeks) - Yes/No
(B) Intermediate Sabre Course
Wednesday 7.00-8.20pm (£100 – six weeks) - Yes/No
Cost includes coaching at club plus supply of basic equipment if required.
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