WEST WYCOMBE PARK POLO CLUB                

Membership Application Form 2008

 

 Title

 

 Surname

 

 Forenames

 

 D.O.B.

 

 Address

 

 

 

 

 

 Handicap

 

 Umpire Grade

 

 Mobile Number

 

 Home Number

 

 Work Number

 

 E-mail address

 

 

 

 Type of Membership

 

 Please tick

 

 

 £650.00 - Full Summer Season

 

 £350.00 – First Full Summer Season Hiring Ponies from Club Coaches

 

 £350.00 - Associate Member – chukkas only (max 10 times per season)

 

 £350.00 - Groom – Tournament Playing

 

 £100.00 - Student (in full time education)

 

 £  50.00 – Pony Club

 

 £  25.00 – Groom – Chukkas only

 

 £350.00 – Joining Fee

 

In addition to the above all playing members are required to be members of the Hurlingham Polo Association and the British Horse Society. Costs of both can be found on the appropriate forms.

 

2008 WWPPC Conditions for Membership

DISCLAIMER

I recognise that polo is an aggressive, physical sport which, by its nature, involves a high risk of injury and damage to persons, animals and property, not only to the persons who are engaged in playing polo but also to bystanders and their personal property.  I also realise that the Club cannot control the actions of members of other persons playing polo or otherwise on the Club’s premises, nor the actions of the animals, and that the Club cannot and does not guarantee the safety of members or other persons or their animals or property while on the Club’s property or while using the Club’s facilities.  I accept full responsibility for our own safety, the safety of members of my family, guests, employees or other persons from time to time using the Club’s facilities as my invitees, and the safety of all their property (including horses and other animals).  I shall hold harmless and fully indemnify the Club in respect of all acts of my invitees or their respective animals.

 

PUBLIC DOMAIN PERMISSION

I hereby authorise photographs taken of me, my family and guests throughout the polo season to be published in the local and national press and/or on the internet for information or publicity purposes.  I understand that WWPPC will select photographs for publication with care and respect for those shown. Independent Press photographers are excluded.

 

 

Signed:                                                                                                                                    Date:

 

New Members are required to be proposed by a member of Committee member or of a Sub Committee.

 

Please send THREE FORMS and THREE CHEQUES

 

Please make your subscription cheque payable to West Wycombe Park Polo Club Limited

Please make you HPA Registration cheque payable to the “HPA”

Please make your BHS cheque payable to the British Horse Society         (If you are already a member of the BHS please just

                                                        advise us of your BHS membership number).

 

□ I request that this information remain private within WWPPC.  This information may not be released for any purposes, to anyone, without my expressed permission.

 

Note: We have been asked by the HPA to send a list of fully paid members to them by the May 1, 2008.

 

Hon. Sec. Mrs P. Lamb, Upper Farm House, Hammer Lane, Warborough, Oxon OX10 7DJ      ': 01865 858475 Fax: 01865 858173