Please help us to gain a profile of the users of our services by indicating below Identity Required

your ethnic origin. This will help us to ensure that we are serving all areas of
the community. Senior Citizen Bus Pass, Pension Book or Birth Certificate
White Disabled Blue Badge or Letter from Benefits Agency
o British
o Irish
Incapacity Benefit * Current Letter of Entitlement from Benefits Agency Culture, Sport & Community Learning
o Other White background (please write in)_____________________________ Unemployed * Current Job Seekers Letter from Job Centre/Giro Cheque/
Signing on book
Mixed
o White and Black Caribbean Student (16+ in Student Union Card or *Current Letter from College or School
o White and Black African Full Time Education) Redbridge Leisure Pass
o White and Asian Income Support * Current Letter of Entitlement from Benefits Agency
o Other Mixed background (please write in)_____________________________ Giro Cheque or Benefit Book/Bank statement showing
receipt of income support
Asian or Asian British
o Indian Housing Benefit/ * Current Letter of Entitlement from LBR Payments & Benefits
o Pakistani Council Tax Service or Council Tax/Rent Statement
o Bangladeshi Benefit
o Other Asian background (please write in)______________________________ *Within one month
Black or Black British
o Caribbean Please hand in your application form to:
o African
o Other Black background (please write in)______________________________ Ashton Playing Fields, Chigwell Road, Woodford Bridge
Ilford Swimming Pool, High Road, Ilford
Chinese or Other ethnic group
o Chinese First Stop Shop, Lynton House, 255-259 High Road, Ilford
o Other (please write in)____________________________________________ Your Redbridge Leisure Pass will be sent to you within 10 days. However, if Leis
Information detailed on this form will be transferred to a computer database. You will you take your application to the First Stop Shop, it will be processed while you ure
only be sent Culture, Sport & Community Learning information relevant to your wait providing you are able to produce all the necessary ID. Nam Pas
application. You will not receive junk mail as a result of completing this form. If you do e...... Sar s
not wish to be included on the mailing list please tick this box: o
For more information please telephone the Leisure Pass administration office .........ah-J
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a
on 020 8708 3095 or write to London Borough of Redbridge Leisure Pass Post .........alen
cod ........t.ine
Administration, 8th Floor Lynton House, 255-259 High Road, Ilford IG1 1NY or e...... IG8 .........
......... 9SB .....
Official Use Only visit the website: www.redbridge.gov.uk/leisure Expi
ry D
.........
...........
ate.. 3 .........
..........5.0 ....
Date received: ______________________ by: ____________ ........7.
.........
Date of Expiry: _____________________________________ Photograph
Hainault Golf Course Pass .........
......
This offers reduced rates to residents meeting the Leisure Pass criteria and is
Date sent: ______________________ by: ____________ issued directly by Essex Golf Ltd at the Golf Course in Romford Road, Chigwell.
Telephone: 020 8500 2470.
ID provided: _____________________________________

ID checked: Yes / No
 What is the Redbridge Leisure Pass? Redbridge Culture, Sport & Community Redbridge Leisure Pass Application Form
The Redbridge Leisure Pass gives you access to some recreation facilities run Learning Events You MUST complete all parts of this form in order to receive your Leisure Pass
by the Borough at a discount off the normal adult price allowing use on Culture, Sport and Community Learning run children’s holiday, half term
Monday to Friday each week between 9am and 5pm. The Leisure Pass gives courses and shows at discounted prices for Leisure Pass Holders. In order to First Name: __________________________ Date of Birth: _______________
holders day membership to Redbridge Sports & Leisure Centre at the above take advantage of these discounts, you must complete your child’s details on
times, with off-peak rates being charged. Please contact the facilities direct for the application form when applying and provide sight of your child benefit Surname: ____________________________________________________
fees and charges. book. Title: Mr / Mrs / Miss / Ms (please circle as appropriate)
Address: ____________________________________________________
Where can you use the Redbridge Leisure Culture, Sport & – Book & Media Festival
Community Learning ____________________________________________________
Pass? Events
– Dance Festival
Allotments – Discounts available at all Council Tel: 020 8708 3044 – Outdoor Theatre _________________________ Postcode: __________________
Tel: 020 8708 3091 managed sites
– Healthy Lifestyles Programme Telephone: ____________________________________________________
* Fullwell Cross Swimming Pool – Swimming, Fitness Gym
Tel: 020 8550 2366 Discounts available to Leisure Pass holders and their children under the age of 16. Children Under 16 (only applicable when booking Culture, Sport & Community
Learning Events)
Ilford Swimming Pool – Swimming, Fitness Gym
Tel: 020 8553 0639 Sight of Child Benefit Book will be required for each child
Who is entitled to apply for a Redbridge
Cricklefield Athletics Stadium – Athletics Leisure Pass? Full Name:___________________________M/F Date of Birth: ____________
Tel: 020 8553 0639 The Redbridge Leisure Pass is available to adult residents of the London Full Name:___________________________M/F Date of Birth: ____________
Ashton Playing Fields – Athletics, Fitness Gym Borough of Redbridge who are Senior Citizens (male or female over 60
years), unemployed, disabled, a full time student aged 16 and over, or Full Name:___________________________M/F Date of Birth: ____________
Tel: 020 8559 0486
receive one of the following: Incapacity Benefit, Income Support, Housing Full Name:___________________________M/F Date of Birth: ____________
Wanstead Leisure Centre – Fitness Suite and Squash only between Benefit and/or Council Tax Benefit.
Tel: 020 8989 1172 4.00-5.30pm Monday-Friday Full Name:___________________________M/F Date of Birth: ____________
Redbridge Sports & Leisure – Gym, Aerobics, Yoga, Badminton, Squash, In the case of senior citizens, and people with a permanent disability, the pass M/F = Male or Female (please circle as appropriate)
Tel: 020 8498 1000 – Tennis, Table Tennis & Racketball will have no expiry date and will remain valid as long as applicants remain
Category
Please tick the appropriate box – Unemployed o Senior Citizen o
resident in the Borough.

Discounts at the above facilities only apply to the Leisure Pass holder and not Student o Income Support o Housing Benefit o
Incapacity Benefit o Disabled o Council Tax Benefit o
to their spouse or children. The Leisure Pass will be renewable every 6 months

New Application o Renewal o

How to obtain your Redbridge Leisure Pass I confirm that the information provided is correct.
* Please note that Fullwell Cross was closed on 1 April for approximately
To obtain a Redbridge Leisure Pass please complete the attached form and Should my circumstances change or should I move out of the Borough,
18 weeks for essential maintenance works and refurbishment.
hand it in to any of the addresses listed. You will be required to provide I will notify Culture, Sport & Community Learning immediately.
2 passport photographs, proof of address and the identification listed
overleaf. Signed: ______________________________________Date: _________________