Type of Membership Amount 1st swimming member in the family £47 2nd swimming member in the family £42 Any subsequent swimming members £36 Non Swimming members £12 Membership Form UASC Membership renewal form. Full Name of First Member* First Last Type of Membership*Please Select Membership Type.£47 - 1st Swimming Member£42 - 2nd Swimming Member£36 - 3rd Swimming Member£12 - Non Swimming MemberClubAdd Member No 2 ?* NO YES Full Name of Second Member* First Last Type of Membership*Please Select Membership Type.£42 - 2nd Swimming Member£47 - 1st Swimming Member£36 - 3rd Swimming Member£12 - Non Swimming MemberClubAdd Member No 3 ?* NO YES Full Name of Third Member* First Last Type of Membership*Please Select Membership Type.£36 - 3rd Swimming Member£47 - 1st Swimming Member£42 - 2nd Swimming Member£12 - Non Swimming MemberClubAdd Member No 4 ?* NO YES Full Name of Fourth Member* First Last Type of Membership*Please Select Membership Type.£12 - Non Swimming MemberClub£47 - 1st Swimming Member£42 - 2nd Swimming Member£36 - 3rd Swimming MemberAdd Member No 5 ?* NO YES Full Name of Fifth Member* First Last Type of Membership*Please Select Membership Type.Club£47 - 1st Swimming Member£42 - 2nd Swimming Member£36 - 3rd Swimming Member£12 - Non Swimming MemberAdd Member No 6* NO YES Full Name of Sixth Member* First Last Type of Membership*Please Select Membership Type.Club£47 - 1st Swimming Member£42 - 2nd Swimming Member£36 - 3rd Swimming Member£12 - Non Swimming MemberContact Information Changes Since last Renewal ?*Please SelectYESNOAddress* Street Address Address Line 2 City County / State / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Home Phone*Mobile Phone*Medical Information Changes Since last Renewal ?*If you answer Yes to this question we will contact you to discuss the medical Information in person.Please SelectYESNOContact Email Address*Please provide a valid email address which will be used by UASC or ASA Membership to contact you Enter Email Confirm Email Mailing Group Consent*I give permission to be invited to the UASC Mailing GroupsPlease SelectYESNOPhoto / Video Permission Consent*I consent for photos / videos to be taken by UASC and used for training, promotional, and celebration of achievement purposes in line with our Data Protection Policy.Please SelectYESNOData Processing Consent*I confirm that i have authority to give consent on behalf of the names listed within this application. I consent to all data submitted can be collected, stored and used to process this membership application to both UASC & ASA membership, in line with our Data Protection Policy.Please SelectYESNOTotal £ 0.00 CAPTCHA