Statement of Agreement

Thank you for your interest in joining Panshanger Anglers.

Please complete the Statement of Agreement form below . This will be the information that the Club we will hold with regard to your membership and confirms that you agree to abide by our Club Rules and Constitution. In the case of junior members it also confirms parental consent.

Once submitted and once payment has been received, our Club Secretary will send you your membership card, parking permit and details for access to Panshanger Park and our waters.

Statement of agreement and parental consent

Membership Type(Required)

Adult Membership

Name(Required)

Prefix First Last

Date of birth(Required)

You must be aged 18 or over to apply for adult membership.

Address(Required)

Start to type your address below

Street Address Address Line 2 City County Postcode

Mobile Phone(Required)

Home Phone (if different)

Email(Required)

Enter Email Confirm Email

Junior Membership & Parental Consent

Section 1: Junior Member Details

This form must be completed by a parent or legal guardian for all junior members under 16 years of age.

Name(Required)

Prefix First Last

Date of birth(Required)

Age

Address(Required)

Start to type your address below

Street Address Address Line 2 City County Postcode

Medical Conditions / Allergies / Dietary Requirements

Section 2: Parent / Legal Guardian Contact Details

Name(Required)

Prefix First Last

Relationship to Child(Required)

Primary Phone Number(Required)

Emergency Contact Number (if different)

Section 3: Understanding of Club Rule 16 (Supervision Requirement)

Please read and initial the box to confirm you understand the club's mandatory supervision rule: Club Rule 16: "Juniors under 16 years of age must be accompanied at all times by a responsible adult aged minimum 21 years who remains wholly responsible for the conduct and safety of the junior at all times."

Club 16 Rule(Required)

I confirm that I have read, understood, and agree to abide by Club Rule 16. I accept full responsibility for ensuring my child is accompanied by a responsible adult (aged 21 or over) at all times whilst on club waters or property. I understand that club bailiffs and volunteers do not provide child supervision.

I agree

Section 4: Nominated Responsible Adults (If not the Parent/Guardian)

If you (the parent/guardian) will not always be the person accompanying the junior member to club waters, please print the name(s) of the responsible adult(s) aged 21 or over whom you officially appoint to look after your child in accordance with Rule 16.

Name

Prefix First Last

Name

Prefix First Last

Section 5: Photography & Media Consent

From time to time, the club may take photographs during matches or events for our website, social media, or newsletters (in line with Angling Trust safeguarding guidelines).

Consent(Required)

YES, I consent to photographs of my child being taken and used for club publicity.

NO, I do not wish for photographs of my child to be taken.

Section 6: Declaration and Signature

I confirm that the information provided is accurate and that I agree to my child joining Panshanger Anglers under the terms of the club constitution and safeguarding policies.

Name(Required)

Prefix First Last

Agreement

Agreement terms(Required)

I have received a copy of the Panshanger Anglers Club Rules and accept the rules as laid down therein. I further agree to any amendments that may be passed by the membership at any subsequent meeting.

I have received a copy of The Panshanger Anglers Constitution and accept the terms as laid down therein. I further agree to any amendments that may be passed by the membership at any A.G.M.

I agree to the above statements.

Are you over the age of 18?

Yes

Full name of parent or guardian if under 18 years old(Required)

Prefix First Last

Name(Required)

Please enter your name as confirmation. By submitting this form, I confirm that the information provided is accurate.

Prefix First Last