Birtley AC Membership Application

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Club Membership renewal (current members only)

Club Membership renewal (current members only)

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£35.90

£0.00 - £60.00

£25.00

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Yearly subscription for Birtley AC which runs April 1st to March 31st of the following year. Payment can be made by credit/debit card, cash or cheque.

If you wish to pay by cash or cheque, please choose that option on the form and continue through checkout. You will not be asked for any card details but we need you to complete the checkout procedure to obtain your membership details. Thank you.

Surname *

First name *

Date of Birth

Any changes to your subscription since last year? e.g. if this is a family membership, are all the members reapplying? Has anyone changed their mind about EA registration? Please provide details of any changes here.

If there are changes regarding any medical condition or disability that the club should be aware of, please give details (or state none) *

Which (if any) of the following methods of contact would you prefer? Select all that apply Text FB Messenger Occasional email with news or upcoming race info

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Club Membership renewal (current members only)

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