Membership
Blackheath Football Club Ltd 2012/2013 Membership Application Form
Subscriptions are now due. Please print out and complete this application form in full (Block Capitals please), and return it with your subscription to: Peter Brown & Mandy Allen, Membership Office, 74 Old Dover Road, Blackheath, London SE3 8SY tel 020 8293 5980 email: membership@blackheathrugby.co.uk
Membership Number…………………… New Member ………..
Title………Fore names………………………………………….Surname……………………………………………………………………..
Address…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………..……Post Code………………………Tel Home……………………………Office……………………Mobile……………………………………..
Occupation………………………………………….
Email…………………………………………………………………………………
Please do not provide your email address if you DO NOT wish to receive communications from the Club.
Season ticket Member £150 …………. With stand seat £180……… (No car parking season tickets available due to restricted car parking at the Rectory Field)
Mens Playing £150 (£140 if paid before 10th October 2012)……………..
Please note that players other than the Men’s 1st squad must have paid their subscriptions of £150 (£140 if paid before 10th Oct) to be eligible for team selection and be covered by the RFU insurance.
Previous club if new……………………………………………….. Main playing position……………...............................
Parent/Guardian of Mini/Junior & Parent/Guardian of U18 players in 2011-2012
£90……… With stand seat £120 ……… (No car parking season tickets available due to restricted car parking at the Rectory Field)
Friends of the Club ……………..Members who are keen to support the Club financially by making a minimum donation of £500 plus their £150 membership fee. Friends meet on match days in the Barbarians Bar and may bring in one guest free. If you would like to be contacted to claim gift aid for the above donation please tick here……..
Friend of the Club 2012 …………. Members who are able to support the Club financially by donating £100 per month. This includes the season ticket membership as well as being eligible for an annual draw. Please contact the membership office if you would like to receive details.
Full Time Student or Youth Under 21 £80
Player………………Non Player………………..students please send copy of Student Card. All rights as Season Ticket Membership
Club Membership:………………….. £50 includes benefits except free access to first team home games and the facility to apply for International match tickets at Twickenham unless a social member prior to 2005/6.
School Age: ……………..Free to non-players who are full time at school. Includes all appropriate membership benefits and free access to home games with an adult (excluding Cup matches, special games and facility to apply for International Tickets).
I apply for membership of Blackheath Football Club Ltd, and agree to abide by the Club rules. I enclose a cheque made payable to Blackheath Football Club Ltd for £ ……………………
Signature……………………………………………………..Date…………………………..
Data Protection Act: Members wishing to verify their computer details should contact the Membership Office at the address shown above
Women Players: please contact Aisling Hogan at Blackheath Rugby, The Rectory Field, Charlton Rd, Blackheath, London SE3 8SR m 07961 577433 or email blackheathwomen@googlemail.com
For other Club details please tick Lottery details………………..Development Fund Details………………………..
Subscriptions are now due. Please print out and complete this application form in full (Block Capitals please), and return it with your subscription to: Peter Brown & Mandy Allen, Membership Office, 74 Old Dover Road, Blackheath, London SE3 8SY tel 020 8293 5980 email: membership@blackheathrugby.co.uk
Membership Number…………………… New Member ………..
Title………Fore names………………………………………….Surname……………………………………………………………………..
Address…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………..……Post Code………………………Tel Home……………………………Office……………………Mobile……………………………………..
Occupation………………………………………….
Email…………………………………………………………………………………
Please do not provide your email address if you DO NOT wish to receive communications from the Club.
Season ticket Member £150 …………. With stand seat £180……… (No car parking season tickets available due to restricted car parking at the Rectory Field)
Mens Playing £150 (£140 if paid before 10th October 2012)……………..
Please note that players other than the Men’s 1st squad must have paid their subscriptions of £150 (£140 if paid before 10th Oct) to be eligible for team selection and be covered by the RFU insurance.
Previous club if new……………………………………………….. Main playing position……………...............................
Parent/Guardian of Mini/Junior & Parent/Guardian of U18 players in 2011-2012
£90……… With stand seat £120 ……… (No car parking season tickets available due to restricted car parking at the Rectory Field)
Friends of the Club ……………..Members who are keen to support the Club financially by making a minimum donation of £500 plus their £150 membership fee. Friends meet on match days in the Barbarians Bar and may bring in one guest free. If you would like to be contacted to claim gift aid for the above donation please tick here……..
Friend of the Club 2012 …………. Members who are able to support the Club financially by donating £100 per month. This includes the season ticket membership as well as being eligible for an annual draw. Please contact the membership office if you would like to receive details.
Full Time Student or Youth Under 21 £80
Player………………Non Player………………..students please send copy of Student Card. All rights as Season Ticket Membership
Club Membership:………………….. £50 includes benefits except free access to first team home games and the facility to apply for International match tickets at Twickenham unless a social member prior to 2005/6.
School Age: ……………..Free to non-players who are full time at school. Includes all appropriate membership benefits and free access to home games with an adult (excluding Cup matches, special games and facility to apply for International Tickets).
I apply for membership of Blackheath Football Club Ltd, and agree to abide by the Club rules. I enclose a cheque made payable to Blackheath Football Club Ltd for £ ……………………
Signature……………………………………………………..Date…………………………..
Data Protection Act: Members wishing to verify their computer details should contact the Membership Office at the address shown above
Women Players: please contact Aisling Hogan at Blackheath Rugby, The Rectory Field, Charlton Rd, Blackheath, London SE3 8SR m 07961 577433 or email blackheathwomen@googlemail.com
For other Club details please tick Lottery details………………..Development Fund Details………………………..
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