Join Crusaders AC
Print out the following form and send it in with the appropriate membership fee to :
The Treasurer Crusaders AC Irishtown Stadium, Irishtown, Dublin 4 If signing up for family membership please list names of all family members. Name(s) : ___________________________________________________________________________________ Address : ___________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ Home phone : ________________________________________________________________________________ Work phone : ________________________________________________________________________________ Mobile : ____________________________________________________________________________________ Email : _____________________________________________________________________________________ By entering an email address above I agree that it may be entered into a club database for the sole purpose of official club communications and for AAI Registrations. Date of Birth : _____________________________________________________________________________ County / Country of Birth : _________________________________________________________________ Event of interest & Previous bests if applicable _____________________________________________________________________________________________ _____________________________________________________________________________________________ If you have been registered with another Irish club in the past 3 years please state which club and the year here. _____________________________________________________________________________________________ If the proposed member is under the age of 18 the signature of a parent or guardian is required. ______________________________________________________________________________________________ Please Circle below; I enclose the appropriate fee for Senior (85) / Junior (40) / Student (45) / Patron (20 or nominative) / Family Membership (140)