Bath Lacrosse Club – Membership 2020/21
To be completed by parent/guardian if under 18 years of age.

Payment should be via BACS to:
Bath Lacrosse Club, Account No 44077668, Sort Code 30-98-97 Reference SUBS

Male/Female/Prefer not to say
Please include post code
Number of Responsible Adult if U18
If U18 this must be the e mail for the responsible adult
England Lacrosse registration number
Sports related qualifications