Membership application form - Midland Sailing Club

Name of Applicant*
First Last
Gender*
- Male
- Female
- Prefer not to say
Date of birth*

DD
MM
YYYY
Ethnicity*
Category of membership*
Parent/Guardian*
First Last
Email*

Email Contact of parent/guardian
Family members*
Name Gender DoB Ethnicity Disability Regular sailor?

For family members please gives names of all members of the family and dates of birth of children under 18 and those in full time education up to the age of 22.
Home address*
Street Address Address Line 2 City Postcode
Contact telephone (required)*
Email address*
Tell us about your boat(s)
Boat/board type or class Boat name Sail no. Indoor / outdoor storage required?

All dinghies, windsurfers and model yachts brought to Midland Sailing Club must be insured.
How did you hear about us?
Membership contact details*
- I am happy for my contact details to be shared with other members of the sailing club.
Membership Subscription Payment*
- Annually (bank transfer)
- Monthly (Standing Order)
- Don't Know

Name	Gender	DoB	Ethnicity	Disability	Regular sailor?

Boat/board type or class	Boat name	Sail no.	Indoor / outdoor storage required?