Online Membership Form – DACORUM INDIAN SOCIETY

Dacorum Indian Society Membership Application Form Year 2019-2020

Form to be completed by the principle Adult applicant

(* denotes mandatory fields).

Full T&C's available here Please read prior to submission - thank you. SECTION 1*

PLEASE COMPLETE THE FORM AND SUBMIT AT THE END.

Principle Header

Title:*

First Name:*

Surname:*

Gender:*

Female

Male

Address Line 1:*

Address Line 2:

Town/City:*

County:*

Post Code:*

Home Tel. No.:

Area Code

Phone Number

Mobile No.:*

E-mail:*

E-mail confirmation:*

Profession:

Preferred method of communication You can contact us anytime to be removed or change this:*

Post

Add phone no. to DIS WhatsApp group?:*

Yes

Second Adult text

Title1:

First Name1:

Surname1:

Gender1:

Female

Male

E-mail1:

Profession1:

Mobile No.1:

Would you like to receieve DIS Email?1:

Yes

Add phone no. to DIS WhatsApp group?1:

Yes

1A Text

Title2:

First Name2:

Surname2:

Gender2:

Female

Male

E-mail2:

Profession2:

Mobile No.2:

Would you like to receieve DIS Email?2:

Yes

Add phone no. to DIS WhatsApp group?2:

Yes

1A Text(1)

Title3:

First Name3:

Surname3:

Gender3:

Female

Male

E-mail3:

Profession3:

Mobile No.3:

Would you like to receieve DIS Email?3:

Yes

Add phone no. to DIS WhatsApp group?3:

Yes

1A Text(1)(1)

Title4:

First Name4:

Surname4:

Gender4:

Female

Male

E-mail4:

Profession4:

Mobile No.4:

Would you like to receieve DIS Email?4:

Yes

Add phone no. to DIS WhatsApp group?4:

Yes

Children Text

1A Text(1)(1)(1)

First NameC1:

SurnameC1:

GenderC1:

Female

Male

Date of birthC1:

child's interestsC1:

1A Text(1)(1)(1)(1)

First NameC2:

SurnameC2:

GenderC2:

Female

Male

Date of birthC2:

child's interestsC2:

1A Text(1)(1)(1)(1)(1)

First NameC3:

SurnameC3:

GenderC3:

Female

Male

Date of birthC3:

child's interestsC3:

1A Text(1)(1)(1)(1)(1)(1)

First NameC4:

SurnameC4:

GenderC4:

Female

Male

Date of birthC4:

child's interestsC4:

TnC Text

TERMS & CONDITIONS:

1	Membership year runs from 1st July to 30th June2	Fee is not refundable if membership is terminated part way through the membership year3	Single membership can be upgraded to family membership by payment of the full difference in fee4	Membership cannot be changed from family to single during the membership year5	Each membership must have at least one adult aged 18 or over6	Family membership covers only permanent residents living at the one address7	Only Adults and children named on this form will be treated as members8	Family membership fee applies where there is one or more person(s) listed on the form9	Single membership applies where there is a maximum of one person named on the form10	If memberships is not renewed within 30 days of expiring an additional fee £5.00 administration charge will become payable11	It is the responsibility of the person signing this form to ensure he/she has consent from all the listed people on the form to have their details declared here as well as ensure accuracy of all information provided.  With all the terms and conditions being accepted by all the people listed on this form12	Membership is required to attend all DIS events, activities and clubs unless otherwise stated13	DIS reserves the right to give priority to members for events, activities and clubs14	Non-members may be allowed to attend events, activities or clubs at a cost15	For all DIS events the aarti money is to be deposited into DIS account and ring fenced for charitable distribution by DIS16	DIS does not accept liability for any damage to members and non-members personal possessions whilst at a DIS event, activity or club17	DIS does not accept responsibility for child member's safety and it is the sole responsibility of the adult members to ensure their children engage safely in activities at DIS organised events and clubs.18	Members are responsible for their own health and safety when participating in any DIS activity, event or club19	Any damage caused by a member at the venue hired by DIS will have to be paid for by the member or the principal member20	Postage will only be used if email is not a preferred method of communication21	If communication method of "Post" is selected, DIS reserves the right to make an additional charge to cover the cost of printing and postage22	All the details provided on this form will be stored electronically. DIS will retain the information (including personal data) supplied on paper or electronically for the purpose of administering and managing DIS events, activities and all other services provided by DIS. The information will be kept securely, and will be kept no longer than necessary. It will not be shared with anyone outside of the DIS Committee or with any third party organisation.  The information provided on this form will only be used for the purposes of organising DIS events, activities and clubs.23	WhatsApp group is administered by DIS Committee for the purposes of communicating with the DIS community. DIS Committee will post information related to events and members can use it to communicate with the Committee or the DIS community.  Members should avoid posting material which can cause offence to other members.  This would include material which is insulting to person's political belief, cultural belief, religious belief, race and gender.  Members are encouraged not to post video on the WhatsApp group unless they are considered informational for the DIS Community.Any personal, professional, profit based or contentious postings on any DIS social media will need DIS committee approval.  DIS reserves the right to remove such postings deemed to be in breach of DIS terms and conditions.Every effort will be made to keep DIS website up to date with the information of the events and activities organised by DIS.24	By signing this form, you agree to your pictures being used for marketing DIS.  DIS uses many different social media platforms for marketing and communicating with its members, so it's possible member's photographs are uploaded onto social media platforms, DIS website and WhatsApp Group.25	Electronic membership application will deemed as signed with agreement of these T&Cs.Full Terms & Conditions are available online - link provided at the start of the form above.

Membership Fee:*

Family £15

Single £7

Payment method:*

Cash *1

Cheque *2

Electronic *3

Payment Details:

Principle applicant's signature :*

Date:

Agree: