LAMDAA Fishing Club Adult Membership

Form
Please use block capitals.
Personal Details:
Name: .............................................................................................. Date of Birth: .. Age: ...........
Address: ............................................................................................................................................................................
Postcode: ..................... Tel: .......................................... E-mail: ....................................................................................
Medical/ Injury Details:
Detail any medical conditions/ allergies that we should be aware of and any medication
required? ............................................................................................................................................................................
Emergency Contact:
Name: ............................................................................ Tel: ...........................................................................................
Disability
The Disability Discrimination Act 1995 defines a disabled person as anyone with a physical or mental impairment, which has a substantial and longterm adverse effect on his or her ability to carry out normal day-to-day activities.

Do you consider yourself to have a disability? Yes No If yes, what is the nature of your disability?
Please specify:
Volunteer/Helper:
Would you be prepared to become a volunteer or helper at our club?

Yes

No

Membership Fee:
Adult Membership

50

All members over 12 will require a Game rod licence to fish Loughmacrory . Associate/Parental members will have no voting rights at club meetings
or AGM. Membership will run for 12 months from 1st of March each year. Full details available on our website . No guests allowed at LAMDAA
By signing this form you are agreeing to abide by the club rules, constitution, all policies and procedures and code of ethics as well as all other laws
regarding Angling as set out by local Councils, Government and Governing Bodies.

Signed: Date:
Please return forms to the Club Treasurer:
Cheques made payable to LAMDAA Fishing Club
Cahir Mc Govern
16 Pinefield Walk
Omagh
BT797YP

Swimmer
Non Swimmer