Exit Membership form 2020 Birmingham Swifts free and affiliated member registration 2020 Question Title * 1. Your name & email contact:(required to register you as a free member and include you on our mailing list). Question Title * 2. Your date of birth, address & contact telephone number:(for England Athletics registration of affiliated members). Question Title * 3. An emergency contact name, telephone and their relationship to you:(to be used only in the event of an emergency). Question Title * 4. Your gender identity (optional): Female Male Non binary Other (please specify) Question Title * 5. Is your gender identity the same as assigned at birth (optional)? Yes No Prefer not to say Question Title * 6. Your sexuality (optional): Lesbian Gay Bisexual Other (please specify) Question Title * 7. If you are a member of any other running clubs or groups, please let us know, including your England Athletics number if known: Question Title * 8. How did you find out about Birmingham Swifts? Website / internet search Word of mouth Leaflet / flyer Facebook Twitter Other social media LGBT centre Activate Other (please specify) Question Title * 9. Do you have any significant medical condition that may affect your ability to run with us? (All information is kept confidential and only accessible by club committee members and run leaders). No Yes (please specify) Question Title * 10. By completing this form, i am agreeing to the members Code of Conduct and the Data Protection Policy available for review on the website www.birminghamswifts.co.uk. From time to time we may use images taken at our events for publicity and I agree to this. I accept that Birmingham Swifts LGBT Running Club will not be held liable for any injury, loss or illness resulting from my participation in Club events and that I run at my own risk.I agree to Birmingham Swifts using my information reasonably in the management of the club and to contact me as required.I confirm that I will not run if I am showing any flu-like symptoms or have been told to self-isolate (please refer to NHS website for latest advice). I agree to the terms of membership. Done