Cumann Lúthchleas Gael
Youth Membership Application Form
Ainm/Name: __________________________________________________
Seoladh/Address: ______________________________________________
____________________________________________________________
Phone/Fax/Email (if available): ___________________________________
Date of Birth: |___| Day |___| Month |___| Year (e.g. 06 02 90)
I hereby apply to: Austin Stacks Hurling & Football Club for Membership
of the above Club and Youth Membership of Cumann Lúthchleas Gael (The Gaelic Athletic Association)
I subscribe to and undertake to further the aims and objectives of the Club and of Cumann Lúthchleas Gael (The Gaelic Athletic Association), and to abide by its Rules, and I attach herewith the appropriate membership fee as determined by the above Club.
Sínithe/Signed _________________________ Dáta: ___________
Print Name: _______________________________________
Parent(s)/Guardian(s), on behalf of the above named:-
We/I consent to the above Application and to undertakings given by the
Applicant.
Sínithe/Signed ____________________(Parent/Guardian) Dáta ____________
Print Name: ______________________
For Official Use only:
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Youth Membership Application approved by Club Executive on _________ Dáta Sínithe: ______________________________ Club Runaí.
Registered in Central Membership Database on __________
Membership Identification Number: _____________ |