The following information is requested by England Netball to gain an understanding of who is participating in netball and to ensure equality of opportunity. Ethnicity (As defined by the 2011 Census) (Please tick as applicable) Prefer Not To Say Asian or Asian British - Indian White British Asian or Asian British - Pakistani – White Irish Asian or Asian British - Bangladeshi – White Other White Background Asian or Asian British Other Asian Background – – Mixed White & Black Caribbean Asian or Asian British - Chinese – Mixed White & Black African Black or British Caribbean – – Mixed White & Asian Black or British African – – Mixed Other Mixed Background Black or British Other Black Background – – Religion Disability (Please tick as applicable) (Please tick as applicable) Prefer Not To Say Do you consider yourself to be disabled under the Equality Christian Act 2010? The Equality Act 2010 defines a person as disabled Buddhist as an individual that has a physical or mental impairment that has a substantial and long-term negative effect on their ability Hindu to carry out normal activities. Jewish Muslim Prefer Not To Say Sikh Blind or Visually Impaired Any Other Religion Deaf or Hard of Hearing Sexual Orientation Physical Impairment Learning Disability (Please tick as applicable) Prefer Not To Say Social or Behavioural Problems Heterosexual Mental Health Issues Gay Man Multiple Disabilities Gay Woman / Lesbian Any Other Impairment Bisexual Other Membership Fees Please pay the required fee specified in the table below by transfer to the club bank account. Name: Wallingford Netball Club Sort code: 30-99-03 Account Number: 01181456 Reference: Please use reference – “Aff – Player Name” e.g. “Aff – A Brown” If you are unable to transfer the money directly please provide a cheque made payable to “Wallingford Netball Club” with this form. Fees (please tick rate paying and method of payment): Aged 18 or over Aged 16 or 17 (on 01-Sep-18) Membership rate Online Cheque Cash Online Cheque Cash Standard rate £45 £35 * Second family member rate £35 £30 Rate only applies if aged 18 and over and in full-time education Summer taster rate £25 £10 Available from Apr 2019 to July 2019 only Second Claim (affiliated to another South region non-Oxon club) £20 £15 Please provide 1st claim affiliation number: * Valid providing player is a direct relative of the first affiliated player and resident at the same address Volunteering
The following information is requested by England Netball to gain an understanding of who is participating in netball and to ensure equality of opportunity. Ethnicity (As defined by the 2011 Census) (Please tick as applicable) Prefer Not To Say Asian or Asian British - Indian White – British Asian or Asian British - Pakistani White – Irish Asian or Asian British - Bangladeshi White – Other White Background Asian or Asian British – Other Asian Background Mixed – White & Black Caribbean Asian or Asian British - Chinese Mixed – White & Black African Black or British – Caribbean Mixed – White & Asian Black or British – African Mixed – Other Mixed Background Black or British – Other Black Background Religion (Please tick as applicable) Disability (Please tick as applicable) Prefer Not To Say Do you consider yourself to be disabled under the Equality Act 2010? The Equality Act 2010 defines a person as disabled as an individual that has a physical or mental impairment that has a substantial and long-term negative effect on their ability to carry out normal activities. Christian Buddhist Hindu Jewish Muslim Prefer Not To Say Sikh Blind or Visually Impaired Any Other Religion Deaf or Hard of Hearing Sexual Orientation (Please tick as applicable) Physical Impairment Learning Disability Prefer Not To Say Social or Behavioural Problems Heterosexual Mental Health Issues Gay Man Multiple Disabilities Gay Woman / Lesbian Any Other Impairment Bisexual Other Membership Fees Please pay the required fee specified in the table below by transfer to the club bank account. Name: Wallingford Netball Club Sort code: 30-99-03 Account Number: 01181456 Reference: Please use reference – “Aff – Player Name” e.g. “Aff – A Brown” If you are unable to transfer the money directly please provide a cheque made payable to “Wallingford Netball Club” with this form. Fees (please tick rate paying and method of payment): Membership rate Aged 18 or over Aged 16 or 17 (on 01-Sep-18) Online Cheque Cash Online Cheque Cash Standard rate £45 £35 Second family member rate * Rate only applies if aged 18 and over and in full-time education £35 £30 Summer taster rate Available from Apr 2019 to July 2019 only £25 £10 Second Claim (affiliated to another South region non-Oxon club) Please provide 1st claim affiliation number: £20 £15 * Valid providing player is a direct relative of the first affiliated player and resident at the same address Volunteering
WALLINGFORD-NETBALL-CLUB-Affiliation-Form-Seniors_2018-2019.docx