Application form 2009 (for conditions of membership read JOINING UP PAGE)

If you experience difficulty printing out this form, request it as an attachment from splash2008@me.com.
Copies are also available from black box outside number 45 West Road, Saffron Walden.

Remember to include your PAYMENT send to - SCHOOL POOL 51 Ashdon Road, Saffron Walden, CB10 2AQ.
Application forms sent in advance must have arrived NO LATER THAN 11th May 2009 with payment.
Do not post it at the last minute - if your form has not arrived, we cannot process it on 12th May.

Previous member YES / NO (Please circle)

Name Adult One:

Name Adult Two:

e-mail address:(Used for contact and identification if you apply to view the online rota)

Address:

Mobile number: (Must be provided, as it is a condition of membership to have a mobile whilst supervising.)

Please include the following information for each child. Name, age in June 09, school attended and school year.

Child One:

Child Two:

Child Three:

Child Four:

Children attending SWCHS in June 2009 (i.e year 7 and above) may come to the pool without an adult and agree to abide by the rules.
All members use this pool at their own risk. Please note changing rooms are unsupervised.

Amount Paid: (Please circle) - Cheques made payable to SWCHS PTA and Friends.

£50 (Family) £45 (Single parent-One adult only) £30 ( Income Support)

I agree to abide by the rules and undertake poolside supervising duties (See supervising duties on web)

SIGN & DATE:

IMPORTANT! Gift aid benefits us enormously and costs you nothing!

PLEASE SIGN BELOW. THANK YOU.

I want my donation of ...................... to be treated as gift aid and for this charity to reclaim the tax.

Name (of taxpayer):

Address:

Sign & date:

SWCHS PTA and friends. Registered charity 310851