X-Swords Prep Fencing Club

Prep Fencing Course Application Form

Saturday Afternoons - 1.00 pm to 1.30 pm
Web : http://www.xswords.com
 

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Parent or Guardian

Parent / Guardian (delete as applicable)

Title

Mr / Mrs / Ms / Dr (delete as applicable)

Forename

 

Surname

 

Child's Name

 

Child's Gender

Male / Female (delete as applicable)

Child's Date of Birth

Day                     Month                      Year

Child's Current Age

 

Child's Handedness

Left-Handed / Right-Handed (delete as applicable)

Address

 

 

Post Code

 

Phone (day time)

 

Phone (evening)

 

E-mail

 

Medical conditions of which we should be aware

 

How did you hear about us ?

 

Terms & Conditions

  1. Neither X-Swords Prep-Fencing Club, Brian Riseley, his instructors nor members shall, in any circumstances whatsoever, be under any liability to the applicant for any loss, damage or injury (including death), whether accidental or otherwise, arising during, or resulting from participation in fencing activities within the X-Swords Prep-Fencing Club premises or on the Club's behalf.
  2. Payment of any subscription or course enrolment fee to X-Swords Prep-Fencing Club shall constitute an acceptance these terms and conditions.
  3. For the purposes of Data Protection, personal details of applicants are not disclosed to any third party.

Declaration / Consent (to be signed by Parent or Guardian)

Signature of Parent or Guardian

 

Date

 

Please complete this application form and bring it with your payment (cheque or postal order payable to Brian Riseley) on your next visit to X-Swords Prep-Fencing Club. Applications will be accepted in strict order of receipt of both completed form and payment.

Copyright © 2017 Brian Riseley Fencing Coach : X-Swords Prep Fencing Club. Brian Riseley Fencing Coach : X-Swords Prep Fencing Club is a member of the British Fencing Association which is the national body for fencing in the UK.