LCC Membership Application Form
Please fill out this form and then contact the club office on 01-4972428 to complete payment.
Office Hours: 8.25am-11.25am Mon/Tues/Weds and 9am-4.15pm Thur/Fri

The club will only use any data you provide for communication with you regarding membership and club related activities.
Email address *
Subscription Rates 2019/20
Full Name *
Your answer
Address *
Your answer
Date *
Current Date
MM
/
DD
/
YYYY
Telephone *
Mobile, Home, Other
Your answer
Occupation/Current Class & School *
Current occupation or school/college
Your answer
Date Of Birth *
MM
/
DD
/
YYYY
Previous Club(s) *
List any previous clubs for each sport you intend playing in LCC
Your answer
Proposer *
If someone is proposing you to join LCC , list their name here. If not, just enter N/A.
Your answer
Seconder *
If someone is seconding you to join LCC , list their name here. If not, just enter N/A.
Your answer
Primary Sport *
Select the main sport that you wish to play in LCC
Other Sports *
List any other sports in LCC which you intend playing
Required
Membership Category *
** Additional levies may apply for certain sports - see above for table of rates.
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