Title Full name Gender
Please select Male Female Date of birth Address Post code Email address Contact telephone number Contact telephone number (alternative) Current / previous club Period of membership Handicap (if applicable) CDH number Do you wish to make Brocton Hall your home club?
Please select Yes No Emergency contact Emergency contact number Proposer name Seconder name I wish to be considered for the following reasons: Date of application Declaration
If elected I agree to become a Member of Brocton Hall Golf Club and I will be bound by the club's Articles of Association and the Rules of the Club. I agree to either pay in full, any appropriate joining fee or, should I elect to pay by instalments, I will remain liable for the total joining fee until it is fully paid.
Data Protection Opt In
In order to receive relevant marketing material and important information from the Club please tick the relevant boxes below:
England Golf require member email address and date of birth information to be sent to them for the World Handicap System. Do you give consent for us to share this information with England Golf?
Please select Yes No I wish to receive information about the Club’s latest events and special offers
Please select Yes No I give my consent for my image to be used for promotional purposes
Please select Yes No Should you leave the club we would like to continue to hold your personal data so that we may contact you with details about future membership offers. Do you agree to us retaining your personal data for this purpose?
Please select Yes No I confirm that I am over the age of 16 and have read, understood and agree with the way my data will be used by Brocton Hall Golf Club. (If under the age of 16, a parent or guardian must sign this form on your behalf). Signature (Applicant/Guardian) Date Confirm