AL-NAJIYAAT SPORTS MEMBERSHIP FORM
Thank you for your interest in Al-Najiyat sports. We are pleased to offer you this application form.
Membership runs from April 2011 to March 2012. (March 2011 is FREE once registration fee paid)
Membership Charge: Under 12 years = £7.50 12 years and over = £10.00
PLEASE COMPLETE THE FOLLOWING INFORMATION
Please Note: Under 18's must print and hand in the form signed by Parent/Guardian
Participant’s Family Name:
Please let us know your name.
First Name:
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Date of birth:
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Age
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Your Email
Please let us know your email address.
Name of Parent/Guardian: Please state: Mr/Mrs/Miss/Ms/Other (*)
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Present Address:
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Postcode
Please write a subject for your message.
Home Telephone:
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Mobile Number:
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Receive Text Updates?
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Emergency Contact Name & Number:
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Please provide any information regarding medical conditions that may be relevant:
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Please tick which sport activities you wish to participate in:







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Signed:
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Date of application:
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Comments - For Ladies Sports Club Use Only:
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