Idle Athletic Club – Membership Application Form

1. You may join us as a First Claim or Second Claim Member.
2. Membership year runs from April to March each year.
3. Renewing members’ Fees are to be paid by the end of April for the new membership year.
4. Existing members not renewing their membership before the 30th of June will have their membership cancelled as their membership will have lapsed. You will no longer be able to compete as an Idle AC member and you will not be covered by the clubs insurance. Any competitions entered after lapse of membership will be liable to the extra £2.00 unattached levy.
5 Membership includes social membership to Hepworth & Idle Cricket Club.
6. You will be eligible for the club’s annual ballot for a London marathon entry (conditions apply)
7. Cost of membership is £29.00 for the year.
8. New Members pay £15 for 1st year only
9. Second claim members pay £17.

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 *