Idle Athletic Club – Membership Application Form

1. We would love you to  join us as a First Claim or Second Claim Member.
2. Membership year runs from April to March each year.

3. New member fee is £30 with a reduction of £1 for every month after April

4. First claim membership is £30.00 for the year.
5. Second claim membership is £15 for the year.

6. Renewing members’ Fees are to be paid by the end of June for the new membership year.
7. 1st and 2nd claim members will be eligible for the club’s annual ballot for a London marathon entry (conditions apply)
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    Contact & Personal Information

    (Compulsory fields are marked with a * )

    Salutation: MrMrsMissMs

    Your Name *

    Date of Birth *

    Home Phone Number *

    Mobile Phone Number *

    Home Address *

    Postcode *

    Your Email *

    Please confirm your email address *

    Dual Club Membership

    If you are a member of another running club, please enter the club name here and tick your first claim club below:

    First claim club?

    Idle ACother club

    Activities/Disciplines

    Road RunningCross CountryTrail RunningFell RunningSwimmingCycling

    Please tick all that apply.


    Medical Declaration

    Are you registered Disabled? *

    YesNo

    Do you hold a valid First Aid Certificate? *

    YesNo

    If you have any known medical conditions please describe them here.

    Do you carry any medication with you? YesNo

    Are there any emergency procedures of which we should be aware of ?

    Declaration

    I confirm that I am eligible to compete under UKA Rules
    I accept that my personal information will be held on a computer for by the club
    I agree to the disclosure of my personal information to the committee and our sports governing body


    Electronic Signature

    As acceptance of signature tick the box below & enter your initials in the space provided.

    I accept the terms & conditions of Idle Athletic Club *

    Yes, I Accept

    Initials *

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