Required Membership (2008):	Senior £95 / Student , Country , Over 60 - £45 / Junior £40/ Juvenile£15/ Non-Playing £5 (Juvenile (attending Junior school)- one parent or guardian must be at least a non-playing member) Please indicate if you require key(s) for: Courts / Clubhouse / Courts & Clubhouse* (£2 deposit per key must be enclosed). You must be over 18 to have a key to the clubhouse - please ask to be shown how to operate the burglar alarm.
Date of Birth and school (if under 18):	..................................................................................................................................
Previous Clubs (if any):	..................................................................................................................................
Introduced by (if relevant):	..................................................................................................................................
Where did you hear about Hillside LTC?	..................................................................................................................................

Under 18's only - Please provide details of a parent/guardian that we can contact in case of emegency Name........................................................................................................Relationship.......................................... Home tel....................................................Mobile..........................................Work............................................. Address...............................................................................................................................................................

Details of any relevant special care needs, dietary requirements, allergies or medical conditions (continue on back of form if necessary.................................................................................................................................................. ........................................................................................................................................................................... ..............................................................................................................................................................................

Notes:

Our acceptance of this form duly completed, together with the membership fee, entitles the Applicant to provisional Club Membership ONLY. The form will be submitted to the Committee for approval, and the Club shall not be called upon to offer any explanation in the event of the application being rejected. Membership fees will be returned in full to rejected Applicants. Accepted members will be sent a shoe tag as proof of membership, usually within a month of application.. In signing this form you are agreeing to abide by the rules of Hillside LTC and that your membership record may be held on computer, to be used solely for Hillside LTC purposes. The club's policy on Child Protection and other codes of conduct are available in the clubhouse. you must inform the club of any changes to the information given on this form. If you are a parent or guardian signing on behalf of your child then you are also declaring that the information given on this form is correct and that you and your child agree to abide by the club's rules and codes of conduct. Please indicate whether it is acceptable for your child to be included in club photographs: YES / NO (Photos may be used for various HLTC publicity purposes including the web site and local press )

Signature of Applicant:	.........................................................................Date...........................
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Signature of parent/guardian (if applicant is under 18 years old)	.................................................................
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Please return this form, when completed, with your membership fee, to: The Treasurer, HLTC, 59 Dunbar Crescent, Southport, PR8 3AA

* Delete any not applicable.