MEMBERSHIP FORM 2021/2022
ST AUSTELL ASC
To be filled in by the member or Parent/Guardian if under 18
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Email *
First Name *
Last Name *
Address *
Postcode *
Mobile number *
Date of Birth (Day/Month/Year) *
Gender *
PARENTAL/GUARDIAN INFORMATION
(If under 18, please complete this section. Not required if over 18)
Parent/Guardian 1 - First Name + Last Name
Address (if different to above)
Mobile number (if different to above)
Email (if different to above)
Parent/Guardian 2 - First Name + Last Name
Address (if different to above)
Mobile number (if different to above)
Email (if different to above)
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