Membership Form kasc 03/2010

KEIGHLEY AMATEUR SWIMMING

CLUB
Contact Steve or Janet on
01535 646399

MEMBERS NAME ... ……………………………………………

Any information contained on this document
ADDRESS.….…………………………………………………….
will only be used in the processing of
……………………………………………………………………. membership to the ASFGB and the ASA
……………………………………………………………………. through KASC’s affiliation with it. No other
……………………………………………………………………. third party will be allowed access. Once ties are
……………………………………………………………………. broken all data will be disposed of in a timely
POST CODE………………………… manner. A copy of your rights is available on
DATE OF BIRTH…………………… request for the committee.
EMERGENCY
TELEPHONE NO…………………………
e-mail ------------------------@-----------------------
MEMBERSHIP FEE…£38.00 for first child £35.00 for second then £32.00 there after (make payable to KASC )
Please inform the club of any ailments (Diabetes /Asthma etc) or medical equipment used by your child such as an inhaler,
which the club should be aware of.
I hereby confirm that I have disclosed any medical condition, which may affect, or may be affected by the child’s
participation in these activities. I also confirm that I understand that Keigh1ey Amateur Swimming Club cannot be held
responsible for any loss or injury howsoever caused, unless it is as a result of its agent’s deliberate act of negligence.

Code of Conduct for Keighley Amateur Swimming Club.

The swimming club has adopted the Amateur Swimming Association procedures and guidelines for Child
Protection and Bullying.
(Copies available on request or go to the web site www.britishswimming.org.uk)
It is expected that all members of Keighley Swimming Club will:

• Comply with the policies, and codes of conduct set out by the ASA and the club.

• Respect the basic human rights, worth and dignity of each member showing no discrimination on grounds of race,
colour language, religion, gender or social status.

• Observe the authority and decisions of all club and pool officials

I declare that as a member of Keighley Amateur Swimming Club that I accept that good behaviour is a fundamental
condition of participating in the club’s activities and that the committee have the right to exclude any swimmer not
complying with this requirement.

Signed Member ……………………………….. Date

For members under 12

I declare that as a parent Keighley Amateur Swimming Club that I accept that good behaviour is a fundamental condition
of participating in the club’s activities and that the committee have the right to exclude any swimmer not complying with
this requirement. I here by confirm that I have explained the content and implications of this code of conduct to my child.

Signed Parent / carer ……………………………….. Date