Brothers Pearse Registration Form 2019

Brothers Pearse Membership Form 2020

For Existing Adult Members Registered in 2019.
*** Fees - €60 if paid by 31 Dec, €65 by 31 Jan and €70 from 1st Feb***
Name *

First Name Last Name
Your Name *
Choose your name from the Dropdown list above. If it is not there or if you want to update your details please use this form - https://form.jotformeu.com/92726351136355
E-mail *
Phone Number:
(086)1234567

Address

Address
Address Line 2
City	County of Birth
Postcode	Country

Birth Date:

Day Month Year
County of Birth
Any medical conditions the club should be aware of?
Details of Medical Condition
Bank Account Details

93-32-95 -01275094

BIC: AIBKIE2D

IBAN: IE14AIBK93329501275094
Tell us how you have paid your Membership Sub *
Date Payment was made? *

Day Month Year
Date Date Picker Icon
Narrative used on Bank Transfer *
Committee Member Name *

First Name Last Name
GDPR Consent

General Data Protection Regulation

In accordance with the General Data Protection Regulation, or GDPR, your consent is required for the club to collect and store your data and for the club to contact you via email, phone, post, SMS, or other text applications (eg. Whatsapp)

Please note, that Brothers Pearse AC will only use this data in accordance with our GDPR Privacy Policy which is available to view on the club’s website www.brospearse.com

If at any time you wish to see the data held by the club or if you wish for your data to be deleted, please contact the club at info@brospearse.com
Please indicate your consent of the above General Data Protection Regulation *

I consent to Brothers Pearse General Data Protection Regulation Policy
I give consent for Brothers Pearse AC to collect and store the data I provide the club on the registration form. *

Yes
I give consent for Brothers Pearse AC (and coaches) to contact me regarding club training, events or any other matter. *

Yes
Once you submit your application and have paid your sub you will be registered with the AAI. You will also be insured while taking part in club activities.

Thank you!
Should be Empty:

Brothers Pearse Membership Form 2020

Bank Account Details