CLUB
MEMBERSHIP
APPLICATION FORM
Cost - £55
► At least 6 individuals must affiliate to enable club registration, 3 of whom must be adults (age 16 and over) and be listed as
club's officials as per below.
► When supplied via post: please either print and fill out this form with capital letters or save it to your disk, fill out on your
computer, print and sign. Please return to Ray Cavanagh, Weightlifting Scotland, 12 Ashgill Road, Parkhouse, Glasgow G226QH enclosing:
1. This filled out form (both pages),
2. Club affiliation fee £55 (cheque or Postal Order made payable to Weightlifting Scotland),
3. Club's constitution signed and dated by at least two club's officials,
► When supplied online: please download the form to your computer, fill out and save. Please send vial e-mail to
[email protected] attaching:
1. This filled out form (both pages)
2. Club affiliation fee payment £55 (bank transfer confirmation - BACS should be paid to: Royal Bank of Scotland, Weightlifting
Scotland, Sort Code: 83-23-13, Account No. 00626159 with Club's name as a reference),
3. Scanned club's constitution, signed and dated by at least two club's officials,
► There is no need to re-send your club's constitution should it remain unchanged since previous application - this applies
solely to the clubs which were already issued a Weightlifting Scotland club certificate in the past. In such case please tick the
appropriate box on the next page.
Club Name:
Club Address:
Town:
Postcode:
Club Contact Tel:
Club Contact Mobile:
Club e-mail:
Date of application:
CLUB OFFICIAL’S REGISTRATION
1 Name of training venue and full postal address
All addresses given will be checked to make sure the club is fulfilling health & Safety requirements and insurance cover is
appropriate to the club premises
2 Name and address of club Secretary
3 Name and address of club Chair Person
4 Name and address of club Treasurer
5 Name and address of club Coach
CLUB COACHES AND REFEREE’S REGISTRATION
Please state member’s names that have the following awards or awards not listed – Leaders Award – Assistant
Weightlifting Club Coach - Weightlifting Instructor Award – Coach Award – Senior Coach Award – Staff Coach
Award – Referee Award – First Aid
1. Name
2. Name
3. Name
4. Name
5. Name
6. Name
7. Name
8. Name
9. Name
10. Name
Award
Award
Award
Award
Award
Award
Award
Award
Award
Award
Date awarded
Date awarded
Date awarded
Date awarded
Date awarded
Date awarded
Date awarded
Date awarded
Date awarded
Date awarded
If there are more then please attach on a sheet of paper.
Club Training Times
1. Training Days and Times
By ticking this box, I hereby confirm that the club constitution previously supplied to Weightlifting
Scotland remains unchanged.
Signed:
Date:
Checklist
This Form signed and dated
Club constitution signed and dated by at least two club's officials or the above box ticked
£55 Payment fee for registration (cheque/Postal Order/Bank transfer confirmation).
Your application will be rejected shall you fail to complete all of the above.