Online Summer Membership Renewal 2023 Please indicate which type(s) of membership you are renewing * Select… Summer Outdoor Only (May - September) £80 Summer Indoor (May - September) £50 Please complete the above as fully as possible. We are obliged to ensure that all our membership details are accurate and up to date. Our Privacy policy is on display in the clubhouse. Title * Title Mr. Mrs. Ms. Miss Dr. Other First Name * Surname * Address * Mobile or home phone number. Your preferred contact * Email Address Date of Birth * We must register all playing members with the National, County and local bowling associations We are asked by the governing bodies for Bowls, and Sport England, to provide membership profile information. This is only ever provided in aggregate form, but we do need: Which of these best describes your ethnic group? * Select… White British White Irish White Other Mixed White & Black Carribbean Mixed White & Black African Mixed White & Asian Mixed Other Asian Indian Asian Pakistani Asian Bangladeshi Asian Other Black or Black British: Carribbean Black or Black British: African Black or Black British: Other Chinese Other Ethnic Group Prefer not to say Do you consider you have a Disability?*: (Please tick) * Select… 0. No long-standing illness or disability 1. Vision (due to blindness or partial sight) 2. Mobility (difficulty walking short distances, climbing stairs, lifting or carrying objects) 3. Hearing (due to deafness or partial hearing) 4. Learning or concentrating or remembering 5. Mental Health 6. Stamina or breathing difficulty 7. Social or behavioral issues (due to neuro diverse conditions such as Autism, Attention Deficit or Asperges Syndrome) 8. Difficulty speaking or making yourself understood 9. Dexterity difficulties (lifting, grasping or holding objects) 10. Long-term pain or discomfort (that is always present or reoccurs from time to time) 11. Other Prefer not to say If you would like to tell us of another disability please do so here. Select… 1. Vision (due to blindness or partial sight) 2. Mobility (difficulty walking short distances, climbing stairs, lifting or carrying objects) 3. Hearing (due to deafness or partial hearing) 4. Learning or concentrating or remembering 5. Mental Health 6. Stamina or breathing difficulty 7. Social or behavioral issues (due to neuro diverse conditions such as Autism, Attention Deficit or Asperges Syndrome) 8. Difficulty speaking or making yourself understood 9. Dexterity difficulties (lifting, grasping or holding objects) 10. Long-term pain or discomfort (that is always present or reoccurs from time to time) Payment Options: Bank transfer to "West Mersea Bowls Club" Sort code 20-22-67 Account no. 00018937 Reference: "Subs" and your name eg "Jo Bloggs" Cheque payable to "West Mersea Bowls Club" (no "Ltd" please). No cash though, please Please indicate how you are paying * Select… Bank transfer Cheque By typing your name you are signing the form Signature * Date * When you click "submit" this will be delivered to our email inbox