Social Membership Form

BIRTLEY AC

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Birtley Junior XC Relay Results 2024

You may think you're "not good enough" to join a running club (wrong!!) However, you will get much more enjoyment out of your running by joining a club, and Birtley AC would like to give you the opportunity to join at a discounted rate to allow you to progress in your training. This is a social membership only - if you are interested in competing, our full membership would suit you more. However, even with the social membership, you'll benefit from our experienced coaches, as well as the encouragement that running with a (small!) group of people will give you.

Social Membership Application Form

Adult membership £30, Junior £20 (plus fees)

* Indicates required field

Title *

First name *

Surname *

Date of Birth *

Gender *

Male Female

Email - essential, please check your response carefully *

Mobile Number *

Address - house no./name, street name and postcode please *

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? *

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 *

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 *

Please read the club's policy on data protection (on our website) and select yes to give consent to the club storing your details. We will be unable to process your application if you do not give consent.

Do you give your consent for the club to store your details as outlined in the data protection policy? *

Yes

Your details will also be shared with England Athletics. You may choose not to be registered with EA if preferred.

EA Registration *

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:-

Why do you want to be a member of the club? *

Fitness Social reasons

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.

U18s Parental Handover - Please choose one option *

I agree to hand over my child to a coach before each session and collect them personally afterwards I am happy to allow my child to attend club by him/herself I am over 18

Photography consent *

Choose how you would like to receive your payment request for your weekly subs *

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

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, a payment invoice will be sent to your email in the next 48 hours. This can be paid by credit or debit card. If you are unable to pay using these methods, please contact [email protected] and we will try to assist with alternative methods of payment.

Choose your delivery method for invoicing *

Text (easiest, and best for strict email spam filters) Email (check your spam folder if not received in 48 hours)

Submit

Location

Our Club Ethos

We welcome all ages and abilities from 7 upwards. Young or old, fast or slow, everyone is welcome. Come along any Tuesday or Thursday at 6.45pm for a taster session and see if you can catch the running bug!

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