DPLTC Membership Application 2018
* Required
Name of 1st Member
*
Your answer
BTM Number (1st Member)
*
You MUSTinclude your BTM Number below to be eligible to enter the Wimbledon ticket draw:-
Your answer
Date Of Birth
Your answer
Address1
*
Your answer
Address2
*
Your answer
Town / City
*
Your answer
County
*
Your answer
Post Code
*
Your answer
Email Address
*
Your answer
Home Telephone No.
*
Your answer
Mobile Number
*
Your answer
Membership type required
*
FREE Social Membership (2018)
£130 Adult Single
£180 Couples Membership (must be same address)
£190 Family Membership (2 adults + 2 children under 16)
£40 Student Membership (Valid NUS Card)
£40 Junior Membership - U16
£25 Junior Membership - U10
£90 Over 60's Special
£90 Country (outside 15 mile radius)
£125 County Couples Membership (outside a 15mile radius)
£45 Disability Membership
1 Month Membership (date to date)
Team Player \ Performance Player
£50 Corporate Membership
Eastbourne College - Corporate Membership
Required
Name of 2nd Member
Your answer
BTM Number (2nd Member)
Please include your BTM Number below:-
Your answer
Date Of Birth
Your answer
Address1
Your answer
Address2
Your answer
Town / City
Your answer
County
Your answer
Post Code
Your answer
Home Telephone No.
Your answer
Mobile Number
Your answer
Email Address
Your answer
Name of 3rd Member
Your answer
BTM Number (3rd Member)
Please include your BTM Number below:-
Your answer
Date Of Birth
Your answer
Address1
Your answer
Address2
Your answer
Town / City
Your answer
County
Your answer
Post Code
Your answer
Home Telephone No.
Your answer
Mobile Number
Your answer
Email Address
Your answer
Name of 4th Member
Your answer
BTM Number (4th Member)
Please include your BTM Number below:-
Your answer
Date Of Birth
Your answer
Address1
Your answer
Address2
Your answer
Town / City
Your answer
County
Your answer
Post Code
Your answer
Home Telephone No.
Your answer
Mobile Number
Your answer
Email Address
Your answer
Wimbledon Ballot
Please enter me into the Wimbledon ballot and liaise with the LTA on my behalf
Agreement to terms
*
Please agree to the terms below by checking the appropriate boxes
I/We agree to abide by the rules of the club as determined by the committee, and understand the club and Eastbourne Borough Council can accept no responsibility for any injury during club activities.
I/We agree to be contacted by email for news/updates from Devonshire Park LTC
I/We would like to be entered into the AEGON Accreditation Badge draw
I/We would like to be entered into the Wimbledon ticket draw
Required
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
