Nuneaton Harriers - Annual Membership Form
1st April 2024 - 31st March 2025

After you submit your form you will receive an email from the membership secretary confirming both the method of payment and your individual payment amount - please do not pay your subscription until you receive the confirmed amount of your annual membership
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Email *
Full Name *
Title *
Address *
Date of Birth (dd/mm/yyyy) *
Age On Application *
Birthplace *
Home Phone Number *
Mobile Phone Number *
Do you wish to be 1st claim or second claim member *
Previous/Other Athletic Club
Nuneaton Triathlon Club Member *
Do You wish to be a competing  or non-competing member *
What type of membership are you applying for *
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