New Member and Renewal Form 2017

Please complete for all new joiners or renewals. This enables us to keep our records up to date - especially for next of kin contacts in case we need to contact someone in an emergency.

* 1. Personal Details

* 2. Date of Birth

Date / Time

* 3. Reason for Submission

* 4. If you are a new member could you tell us how you found out about the club?

* 5. Please Select the Membership Type

Please transfer the subscription amount using internet or telephone banking to: HSBC Account No. 91501704, Sort Code 40-17-17 using reference 'Smith Subs 2017' where Smith is your surname

* 6. Please Enter Emergency Contact Details

* 7. Please enter details of any medical conditions the coaches shoud be aware of (this will be kept confidential)

Subscriptions to the club will be paid annually. The annual subscription becomes due on the 1st April and should be paid no later than the 30th April. Any payment received between the 1st May and the 31st May will incur a £5.00 administration fee.

The club annual subscriptions include annual affiliation costs to England Athletics (£14 per year) and club affiliation to Triathlon England

Data Protection – any information provided on this form will be used by the Club Management to provide information concerning sporting, social and other club activities. The information may also be provided in a summary form to the governing bodies for statistical analysis. Occasionally name details may be provided to our third party suppliers for the express intention of validating club benefits. Information is never shared with any third parties for them to contact you with marketing or other reasons without your express written consent.