Renewing Junior Member Application Form - Trent Valley Angling (TVA)

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Renewing Junior Members Application Form
Junior Name (as you would like it to appear in your membership book)*

First NameLast Name
Date of Birth*

DayMonthYear
Date
Are you 16 or 17?*

YesNo
Have you been a member in the past 6 months?*

YesNo
If you answered No you are filling in the wrong form please go to the New Juniors Members Application form
Please select a membership type:*
Do you want to be added to the Holme Pit waiting list?*

YesNo
Are junior contact details (number/adress/email) different from the parent/guardian?*

YesNo
Junior Mobile Phone Number (If different from parent)
Please enter a valid phone number.
Junior Email (If different from parent)
[email protected]
Address (if different from parent)

Street Address

Street Address Line 2

City / TownCounty

Postcode
Parent/Guardian Full Name*
Relationship to applicant*
Is parent / guardian a current member of TVA?*

YesNo
Phone Number*
Please enter a valid phone number.
Address *

Street Address

Street Address Line 2

City / TownCounty

Postcode
Parent / Guardian Email*
[email protected]
Consent Statement

I consent to my child becoming a member of TVA.

I understand that TVA is a voluntary organisation run for the
benefit of its members and I agree that it is not reasonable to
expect TVA to be responsible for my child.

I understand that there are hazards associated with the sport of angling and I agree that I remain responsible for my child at all times whilst he or
she is on TVA property or engaged in TVA activities.

I understand and agree that TVA cannot and does not provide
supervision and that my child will be on TVA property and
engaged in the activities of TVA at its own risk.

I understand and agree that my child must comply with all
reasonable rules and conditions of TVA membership.

I understand and agree that neither TVA nor its officers or
committee members shall not be liable for any personal injuries
to members, guest or others on TVA property and shall not be
liable for loss or damage to any property or equipment.

Our GDPR policy can be read at TVA GDPR policy
Parent / Guardian signature: By signing below you agree to the above consent statement*

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Contact in event of an emergency

First NameLast Name
Phone Number*
Please enter a valid phone number.

How do you want to receive your permit?

I will provide a Stamped Addressed EnvelopeCollect inperson (Please call John on 07976 794880 to arrange)I will pay £2 (can be done on the Paypal page) and we will provide the stamp and the envelope
How do you want to pay?*

Cheque(please make cheques payable to 'Holme Pit Action Group')Postal OrderPaypal (link will show after the submit button has been pressed)
If you are paying using Paypal, is your named Parent / Guardian the Paypal account holder?*

YesNoI am not using Paypal
Do the Paypal details match the details you have already filled in on this form for your parent / guardian?*

YesNoI am not using Paypal
If you are paying with a Paypal account that is not your own parent / guardian please enter the name of the account holder in the box below or put 'N/A'*
Upload Photo as .jpeg (PLEASE NOTE A PHOTO OF A PHOTO IS NOT OF ACCEPTABLE QUALITY TO BE REPRODUCED IN YOUR MEMBERSHIP BOOK AND YOUR APPLICATION WILL BE DELAYED UNTIL WE RECEIVE AN ORIGINAL PHOTO OF YOUR HEAD AND SHOULDERS - IF YOU CAN TAKE APHOTO OF A PHOTO YOU CAN TAKE A PHOTO OF YOURSELF!)*

Cancelof
Please tick here if we can contact the junior member by email (If applicable)*

YesNo
I am human*

YesNoNot sure
If you have not received your Membership Book or an email from Trent Valley Angling saying that it is ready to be picked up within 7 days of your application please email [email protected] or contact John (07976 794880).
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Home
FAQs
News
TVA Waters
- How to find TVA Waters >
Gallery
Membership
Contact
Work Parties and Events
Weather
Links