Ashbourne Running Club - Membership Application / Renewal

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Form for membership 1st April 2024 to 31st March 2025

Email *

Name *

Address
*

Postcode
*

Phone Number
*

Gender
*

Male

Female

Date of Birth
*

YYYY

Emergency Contact Name & Relationship to You
*

Emergency Contact Phone Number(s)
*

Membership & Fees

Membership runs from 1st April to 31st March and is renewable annually during March.

Please tick type of membership required.
*

Senior (Age 18+) £15

Junior (Age 15 to 17) £5 Please complete statement on Junior Members below.

Membership fees can be paid in several ways, please tick the one you're using.

Bank Transfer (preferred), please put your name in the reference. Account No 00303499, Sort Code 30-90-25

Cash, please put in an envelope with your name on & hand to any committee member

Conditions of Membership

Ashbourne Running Club will store and use your personal data for the purposes of administering the club and your involvement in club activities. The data will be collected and processed in accordance with our Privacy Policy. I understand that by submitting this form I am consenting to my data being used in this way.

If you have a medical condition that may be adversely affected by running you should seek medical advice before running with the club. I understand members participate in club activities entirely at their own risk.

I have read and agree to abide by the Club Constitution and the Club Code of Conduct – available on the club website www.ashbournerunningclub.org.uk

Signed (Electronic signature or type name)

For Junior Members ONLY (Age 15 to 17)

Junior Members must run with their parent or guardian or nominated responsible adult on club runs. Whilst every effort will be made by the club to ensure the Junior Member’s safety, the club cannot be held responsible for this, and parent’s or guardian’s acknowledgement is required by signing below.

I acknowledge I have read and understand the above statement on Junior Members, and agree to abide by its requirements.

Signed by Parent / Guardian (Electronic signature or type name)

Name of nominated responsible adult (if applicable)

Send me a copy of my responses.

Submit

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