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Membership Application Form
2019-01-18T09:52:11+00:00
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Step
1
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Membership Application Form
Please complete all the required fields. When you are satisfied with the application please use the grey submit
button for us to process your application.
Please select the membership type you require
Single
Joint
Family
Please select the membership category you require
*
Membership Category
Club
Club Swim
Club Student
Club Junior
Climbing
Club Tribe
Club 75
Club Swim 75
Title
Mr
Mrs
Miss
Title
Name
*
First
Last
Address Primary member
*
Address Line 1
Address Line 2
City
State / Province / Region
Postal Code
Email
*
Contact number primary
*
Car Registration
Declaration
I/We have read the Clubs Terms and Conditions of membership which are available on the website and agree to abide by them.
Declaration
*
Yes
Marketing Prefernces
Yes
I am happy to receive information from the club from time to time
Next
Secondary Member Details
Secondary Member Details
Joint
Family
Please select membership type required
Membership Category
Club
Club Swim
Club Student
Club Junior
Climbing
Club Tribe
Please select the membership category you require
Title
Mr
Mrs
Miss
Secondary members Name
First
Last
Address
Address Line 1
Address Line 2
City
State / Province / Region
Postal Code
Secondary members Email
*
Contact Number
Car Registration
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Junior /Synergy Memberships Member Details
First Child
First
Last
Date of Birth
Second Child
First
Last
Date of Birth
Third Child
First
Last
Date of Birth
Next
The information that you have provided on this form will only be used for the purpose of your membership at Charterhouse Club. It may be shared with our third party consultants who support this purpose. It will not be used for additional purposes without your consent. All personal data is collected and processed in compliance with General Data Protection Regulations (GDPR) and other data protection laws. Your rights in respect of your data can be found in the Privacy Policy on the Club’s website.
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