Harlech Triathlon Club

Membership 2021

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* 1. Full name

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* 2. Address (including postcode)

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* 3. Email address

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* 4. Mobile phone number

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* 5. Name and phone number to contact in case of emergency

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* 6. Gender

Male

Female

Other (please specify)

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* 7. Date of birth

DD / MM / YYYY

Date

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* 8. Declaration:
I wish to become a member of Harlech Triathlon Club
I agree to obey the rules and codes of conduct of the HarlechTriathlon Club, the British Triathlon Federation, race organisers and the clubs, leisure centres or venues the club may use
I understand that members participate in all training sessions, races and other events at their own risk

Yes

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* 9. Signed: Enter your full name
(Over 16 signatures only, a parent or guardian must sign on behalf of juniors)

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* 10. Date

DD / MM / YYYY

Date