BIRTLEY AC
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Photos by John Geddes
Photos by Stuart Whitman
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Membership Application Form
NB Please complete the checkout process at the end of this form, even if you plan to pay by cheque at the club - you will be given the option to choose these methods of payments at checkout.
Family membership £95 (current price £45)
:- please add any additional members of your family by completing
this form
- please click on the link for each person you wish to add, you will return to this page once form is submitted. Finally, complete the form below with your own details.
Junior membership £35 (current price £20)
:- complete the form below with the athlete's details - you will need to give your own email, phone number and address at checkout.
Adult membership £60 (current price £25)
:- complete the form below then supply the requested details at checkout (email, phone number and address).
*
Indicates required field
First name
*
Surname
*
Date of Birth
*
Gender
*
Male
Female
Why do you want to be a member of the club?
*
Fitness
Social reasons
Competing
If you have any medical condition or disability that the club should be aware of, please give details (or state none)
Medical Info
*
Do you use a Beta 2 Agonist Inhaler?
*
No
Yes
Consent for Emergency Medical Treatment - There may be occasions where an athlete needs to be treated immediately, particularly in life threatening situations. We need to know that you are happy for emergency medical treatment to be carried out if necessary.
Consent for treatment
*
Yes I consent
No I do not consent
Emergency Contact Name and Tel No.
*
I agree to abide by the Club's code of conduct and always behave in a manner befitting a club member when attending events or representing the club
Code of conduct
*
Yes I consent
No I do not consent
Do you wish to be registered with England Athletics (if you wish to compete you must agree to this). Social members who do not wish to compete may choose not to register
EA Registration
*
Yes I wish to be registered with EA
No I do not wish to be registered with EA
Please read the
club's policy on data protection
(on our website) and select yes to give consent. Your details will also be shared with England Athletics. If you do not consent, we will be unable to process your membership application
Data Protection
*
Yes I agree my details can be shared with EA
No I do not want my details to be shared
The club may need to contact you by email, text etc. with important club info and notifications. Please indicate your preferred method(s) of contact:-
Choose all that apply
*
Email
Text
FB Messenger
I consent to Birtley AC using images of me (or my child) on their website, FB page and other social media. We will comply with your wishes on our own media should you opt not to allow use, but we may be unable to prevent their image from being published by other organisations.
Photography consent
*
Yes I consent
No I do not consent
Our club is run on a purely voluntary basis. If you can help out, please indicate which task(s) would be willing to assist with.
Select all that apply
Assisting training Committee post/administration Fund raising Refreshments and social events Team management Supervision of athletes Other (please state)
Please indicate if you can help with:-
*
Assisting training
Committee post/administration
Fundraising
Refreshments and social events
Team Management (Juniors)
Supervision of athletes
Other (please state in box below)
Other
*
When you click on the Submit button, you will be taken to the payment page. Payment may be made by credit/debit card, or if you'd prefer to pay by cash or cheque at the club, that is a payment option too. Please complete the checkout procedure - you will NOT be asked to provide any card details if you've chosen to pay by cash or cheque, but we'll need your address and telephone number for our records. Thank you.
Submit
Home
Club Info
Club Info
At a Glance
FAQ
Membership Form
Social Membership Form
Contact Us
Noticeboard
News
Club Shop
Our Races
Fixtures, Results & Calendar
The Social
The Social Club
Confessions of a Vet
Photos
>
Photos by John Geddes
Photos by Stuart Whitman
Training
Shortcuts
Useful links
Weekly Training Fees