Membership form 2023/24

Skater Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact Name *

The following contact will be only used in the case of any accident or injury requiring support for the skater.

First Name

Last Name

Contact Consent *

Please tick the box if you CONSENT to Starlight Synchro contacting you regarding club activities using the mobile number(s) provided above.

Please tick the box if you CONSENT to Starlight Synchro contacting you regarding club activities using the email address provided above.

Please tick the box if you DO NOT CONSENT to Starlight Synchro contacting you regarding club activities using the mobile number(s) provided above.

Please tick the box if you DO NOT CONSENT to Starlight Synchro contacting you regarding club activities using the email address provided above.

Information Consent *

Please tick the box if you CONSENT to Starlight Synchro sharing the relevant information above with British Ice Skating and relevant competition organizers on competition application forms.

Please tick the box if you DO NOT CONSENT to Starlight Synchro sharing the relevant information above with British Ice Skating and relevant competition organizers on competition application forms.

Still & Moving Images Consent

Please tick the box if you CONSENT to Starlight Synchro taking photographs & film for teaching purposes to be shared privately with team members.

Please tick the box if you CONSENT to Starlight Synchro taking photographs & film for publicity and promotional purposes to be shared publicly on the club website.

Please tick the box if you CONSENT to Starlight Synchro taking photographs & film for publicity and promotional purposes to be shared publicly on the club social media.

Please tick the box if you CONSENT to Starlight Synchro taking photographs & film for publicity and promotional purposes to be shared publicly on poster, flyers or newspaper articles.

Please tick the box if you CONSENT to Starlight Synchro taking photographs & film to create a DVD of our showcase to be sold to club members & show participants.

Please tick the box if you DO NOT CONSENT to Starlight Synchro taking photographs & film for teaching purposes to be shared privately with team members.

Please tick the box if you DO NOT CONSENT to Starlight Synchro taking photographs & film for publicity and promotional purposes to be shared publicly on the club website.

Please tick the box if you DO NOT CONSENT to Starlight Synchro taking photographs & film for publicity and promotional purposes to be shared publicly on the club social media.

Please tick the box if you DO NOT CONSENT to Starlight Synchro taking photographs & film for publicity and promotional purposes to be shared publicly on poster, flyers or newspaper articles.

Please tick the box if you DO NOT CONSENT to Starlight Synchro taking photographs & film to create a DVD of our showcase to be sold to club members & show participants.

Payment *

Club fees vary depending on the team that you skate with for full details see your team page. Fees should be paid on the 1st of the month for the upcoming month.

I have set up my monthly standing order for club fees to the club account using the skater name as reference.

I agree to providing one month notice via email to the club Secretary before cancelling my standing order.