glenalbyn - Renewal Form

Registration Form

Existing and new members wishing to register for the nine months from end-December 2009 to September 2010 please fill out the form below:

· Registration fee €55 ---------- Competitive Member (€65 if paid after 12 November 2009)

(Competitive Membership allows one to compete in sea swims and swim galas)

· Registration fee €30 ----------- Associate Member (€40 if paid after 12 November 2009)

Please make cheques payable to Glenalbyn Masters and return to:

The Membership Secretary, Glenalbyn Masters,

c/o Glenalbyn Swimming Pool

Stillorgan

Co. Dublin

Or leave in a sealed envelope at the front desk in the pool.

Please complete the form below and amend if your address has changed recently. Please enclose this form with your subscription.

Name:

Address:

Date of Birth:

Registration No. (if known):

E mail:

Mobile phone No:

Full Member:

€55 or €65 (after 12 Nov 2009) enclosed

Associate Member:

€30 or €40 (after 12 Nov 2009) enclosed