Apply for an Actif Gold Card Membership
Date of Birth
Age (on applicaton)
National Governing Body
Are you re-applying for the membership?
Facilities - Please select one Leisure Centre
Carmarthen Leisure Centre
Llanelli Leisure Centre
Amman Valley Leisure
St Clears Leisure Centre
Newcastle Emlyn Leisure Centre
Llandovery Leisure Centre
Coedcae Sports Centre
Please select two activities
Supporting Information: Please upload proof of your Welsh representation (a scan/photo of the NGB letter is suitable or attach an email) Please upload proof of address
We (Carmarthenshire County Council Sport & Leisure Department) would like to be able to retain the above details so that we can then keep you informed about future leisure events that may be of interest to you. We will handle your information carefully and with respect for your privacy.
Please tick here to opt out
Please tick here to opt in
I declare that the information given above is to the best of my knowledge true and correct. By signing the form you are also agreeing to the terms & conditions of the membership.
Signature of applicant*: (*parent or guardian if applicant is under 16 years of age)