APPLICATION PROCESS If you are eligible to join the FANS scheme then please complete the attached application form and return it to the appropriate centre General Manager General Manager General Manager Wycombe Leisure Centre Court Garden Leisure Complex Risborough Springs Swim Handy Cross Pound Lane & Fitness Centre Marlow Wades Park Bucks Bucks Stratton Road HP11 1UP SL7 2AE FREE ACCESS FOR NATIONAL Bucks Tel 01494 688100 Tel 01628 405 200 HP27 9AX SPORTSPEOPLE SCHEME (FANS) Tel 01844 274 200 Please enclose two passport sized photographs and supporting evidence to confirm your www..gov.uk/ involvement in sport at a national level (e.g. letter from National Governing Body). If you wish to have a nominated coach attend to help you train please enclose two passport-sized photographs of the coach (clearly named on the back) and evidence of their coaching qualifications. Your membership card(s) will be sent out to you with a letter detailing the placesforpeopleleisure.org facilities you may access, the terms and conditions and the details of a person to contact prior to using the scheme. Once you have received your FANS card, please contact the named person on the letter to arrange a short meeting to discuss your requirements and the practical arrangements for use during off-peak times. GUIDELINES FOR USE 1. Each FANS member will be entitled to free access of a venue and facility of their choice during off-peak times, when the facility is open, provided there is no disruption to other users and no additional cost is incurred by use of the facility i.e. floodlighting. 2. FANS members will choose their one venue but may choose more than one facility, within the venue, if their training/sport requires this variety. 3. Membership of the FANS scheme is renewable every 12 months providing continued sports participation at a national level is maintained. 4. FANS scheme members will be allowed one coach (free of charge) to help with training if the sport so requires. This person needs to be named on the form and two passport sized photographs supplied. Evidence of coaching qualifications will be required. 5. In return for these benefits, as a condition of the FANS scheme, you will make every effort, within reason, to attend promotional events as requested by Buckinghamshire Council's Sports Development Unit and Places for People Leisure's Management Team. 6. Use of the Gyms: All FANS scheme members must have a full induction. Contact details will be provided in your membership letter. 7. Off Peak Times: 8. Monday to Friday before 5pm 9. All day Saturday and Sunday.

Court Garden Leisure Complex Pound Lane, Marlow, Bucks. SL7 2AE (T) 01628 405 200 Risborough Springs Swim & Fitness Centre Wades Park, Stratton Road , Princes Risborough, Bucks. HP27 9AX (T) 01844 274 200 Wycombe Leisure Centre Handy Cross, High Wycombe, Bucks. HP11 1UP (T) 01494 688 100 Working in Partnership with your Local Authority FREE ACCESS FOR NATIONAL SPORTSPEOPLE SCHEME (FANS) DISABILITY The Wycombe Free Access for National Sportspeople (FANS) scheme is an important Do you have any long standing illness, disability or infirmity? sports development programme which aims to provide support and encouragement to (Long standing means anything which has troubled you over a period of time) the area's leading, talented and elite sportspeople. The scheme provides national level Yes sportspeople with free access to a number of the area's sport and leisure facilities at designated off-peak times for training and development. These facilities are at Wycombe No Leisure Centre, Court Garden Leisure Complex (Marlow) and Risborough Springs Swim and Fitness Centre. If Yes, does this illness limit your activities in any way? ELIGIBILITY Yes The scheme provides opportunities for sportspeople of all ages who currently perform No and compete at a national level. GENDER AGE GROUP ARE YOU? Female Male 16 and under 17-24 1. Currently a member of a national team or squad? (Sports recognised by Sport England) 2. Currently listed in the top ten of any national age group ranking? Sports recognised by Sport 25-34 35-44 England) 45-54 55-64 3. If you are any of the above and reside in Wycombe area you could be eligible to access the scheme. Evidence of confirmation of your involvement at national level will be required from 65+ the appropriate governing body of sport. Please pick which best describes your ethnic origin: PLEASE WRITE CLEARLY White - British Bangladeshi Caribbean Full Name: Indian African Refuse to Answer Chinese Pakistani Other (Please specify) Address:

I have enclosed two passport sized photographs and supporting evidence to confirm my involvement in sport at a National level (e.g letter from National Governing Body). If I wish to have a nominated coach to attend to help me train I have enclosed two passport Postcode: sized photographs of the coach (clearly named on the back) and evidence of their coaching qualification. FANS users must always bring their membership card with them. In return for the benefits of the FANS scheme I agree to abide by the scheme conditions and Home Tel No.: to support or attend promotional activities and events if available. The information on this form contains your personal data. We will record, process and hold your personal data in accordance with the Data Protection Act 1998. We may from time to Mobile Tel No.: time contact you regarding other events and activities which, we believe. Will be of interest to you. E-mail Address: If you DO NOT wish to receive such communication please tick here Team Ranking:

Signed VENUE CHOICE FACILITY CHOICE

Wycombe Leisure Centre Gym Print name Court Garden Leisure Complex Swimming Pool Risborough Springs Swim & Fitness Centre Other, please state below: Date

Nominated Coach