Membership application form - Midland Sailing Club

In order to apply for membership of Midland Sailing Club, please fill in the form below. We will then get in touch with you with any further details. Midland Sailing Club will keep your contact details secure and will not pass them on to any third party.
Name*
First Name Family Name
Email*
Phone
Address*
House Number & Street Locality (eg Edgbaston) City Postcode
Gender*
- female
- male
- other
- prefer not to say
Your Date of Birth*
Date Format: DD slash MM slash YYYY
Ethnicity
Joining Details
- Joining through a SailBirmingham Course
- Joining through the Sailbility Programme
Under 18?
If you are under 18, please also complete the following section:
Legal Guardian
First Name Family Name
If you're under 18, please provide the name of a parent or legal guardian.
Guardian Contact Email

If you're under 18, please provide a contact email address for them.

Under 18?