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.