Almost Athletes Membership Application Form

Membership Year

Please note:  Almost Athletes club contributes £15 EA affiliation fee from each £28 membership fee to England Athletics. The 2021-2022 year will run from 1st April 2021 until the 31st March 2022. Applications for NEW MEMBERS are invited and their membership year will run from now to 31st March 2022.

New Member Application

Applying for membership has two stages ... Payment and Application Form ... please do both WITHIN A PERIOD OF 24 HOURS!

Payment

Electronic payment:

• Account Name: Almost Athletes
• Account Number: 76680668
• Sort Code: 30-98-97
• Account type: Business Account
• Payer Reference : Initials + Surname

Application Form

Before filling in an application form, please click this link to open and read the Privacy statement & Communication preferences.

Almost Athletes offers two options for you to supply your personal details as listed below.

• Using the online form (below) is the most convenient. However, your data will be transmitted to Almost Athletes and to yourself by unencrypted emails that might be read by third parties (human and computer) anywhere in the world, over which Almost Athletes have no control or knowledge.
  1. Scroll down to the online form below and enter your details.
  2. When you click the Submit form button, your data will transmitted by email to the Membership Secretary and you, and also shown as a summary web page, in place of the form.
  3. Note - if the form is still visible after clicking Submit, there is an error in your data and it has not been sent. Please correct the error and click Submit form button again.
• Alternately, download a blank form onto your computer and hand to the Membership Secretary, Alison Hume.
  
  1. Click the link to download the form as a PDF file.
  2. Print the file and fill in using a black pen.
  3. Hand to the Membership Secretary, Alison Hume. To arrange this handover, please email membership@almostathletes.co.uk.

Almost Athletes Membership Form

Title*

First name*

Surname*

Address*

Postcode*

Home Telephone Number

Mobile Telephone Number

Date of Birth*

12345678910111213141516171819202122232425262728293031  Day JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember  Month 19301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003  Year  We need your date of birth for insurance purposes and for England Athletics registration

Gender*

Email address*

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Annual Membership for NEW Members is from Now to 31 March 2022

Application Type ?New Membership £28.002nd Claim Member £13.00Life or Volunteer (non-running)

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Please detail below any disability you have/or any additional support you may require from our Club coaches. If there is no information please write 'None'.

Additional support*

Please detail below any important medical information that our coaches should be aware (e.g. epilpsy, asthma, diabetes, allergies, etc.) If there is no information please write 'None'.

Medical information*

Please check box below to show that your consent to your special category personal data provided in the "Additional Support" and "Medical Information" sections above being shared with coaches for the purposes of my safe participation in Club activity. This data will not be shared or processed for any other purpose.

I consent to sharing Additional Support and Medical Information.

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Emergency Contact One (Name):

Emergency Contact One (Phone number):

Emergency Contact Two (Name):

Emergency Contact Two (Phone number):

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PRIVACY AND DATA SHARING DECLARATION: Please read Club Privacy and Data Sharing notes HERE

By submitting this form, I confirm that I have read and understood the Privacy Statement and how data will be used and shared and am willing to abide by the Club Code of Conduct. Please check to show you agree to the terms of the declaration immediately above.

CLAIMS AND LIABILITY DECLARATION: I understand that running can be a strenuous activity, and that I should not participate unless I am physically able to do so. I accept all risks associated with running, including, but not limited to: the effects of weather, traffic, road or terrain conditions. I hereby waive and release the Almost Athletes Running Club from all claims and liabilities of any kind arising from my participation within the club.

Claims and liability Declaration Checkbox*

I agree to the Claims and Liability Declaration

Payment Method*

Select OneBank TransferNo Payment due