glenalbyn - Renewal Form

Renewal Form

Existing and new members wishing to register for the year from 1 October 2011 to 30 September 2012 please fill out the form below:

· Registration fee €70 ---------- Competitive Member

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

· Registration fee €40 ----------- Associate Member

Please make cheques payable to Glenalbyn Masters and return to:

The Membership Secretary, Glenalbyn Masters,

39 Torquay Wood

Foxrock

Dublin 18

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:

€70 enclosed (€90 if late renewal)

Associate Member:

€40 enclosed