Membership Options - Please choose an option below

	£25.00 - Road Runner and EA Affliliation Fee
	£10.00 - Social Member
	£10.00 - Second Claim Road Runner
	£55.00 - Road Runner Club Membership, Affiliation Fee and Track Fees - First Claim
	£25.00 - Momentum, Club Membership and EA Affiliation Fee

*Please Enter Parent/Guardian Name

*What Is Your Relationship To The Athlete?

* Emergency Contact Details, please give name and telephone number

* Have you previously belonged or do you currently belong to any other Athletics Club - if so which one?

Select Yes No

* If applying for First Claim Membership and you are a member of another Club you must complete a Change of First Claim Club Form online via England Athletics Websites - have you done this

Select Yes No N/A

* Please give details of any medical conditions/health matters/allergies that might affect you whilst taking part in activities, including any medications

* It may be essential at some time for authorised persons to have necessary authority to obtain urgent treatment for you whilst at competition or training. Do you give authority for this

Select Yes No

* Where did you hear about the club?

* Are you a trained First Aider

Select Yes No

* Do you give consent to Cleethorpes Athletics Club taking and using photographic and video media of you for marketing and promotion purposes, including publishing on the club website

Select Yes No

By registering as a member of Cleethorpes Athletics Club you are hereby accepting and agree to abide by both the rules of UK Athletics and the Club Code of Conduct for Athletes which can be found on the club website.  You are also declaring that the following statements are true:  I agree that to the best of my knowledge I am medically fit for taking part in athletics.  I am eligible to compete for Cleethorpes Athletics Club in accordance with UKA Rules,  wear club colours when representing the Club at races or events.  I agree to notify the club of any changes to my personal details and medical information.  Cleethorpes Athletics Club are not under any liability whatsoever in respect to personal injury, loss or damage caused when you are attending club sessions or representing the club at any competition.

I understand personal data collected on this form will be stored electronically and will only be used for the purpose of administration as required by the club. It will only be disclosed to appropriate club officials. I also understand that as a competing member, that data will also be held by England Athletics. 

The Participant shall be deemed to have made themselves familar with, and agree to be bound by the UKA Anti-doping Rules and submit to the authority of UK Anti-Doping in the application and enforcement of the Anti-Doping Rules.  The UKA Anto-Doping Rules apply to entrants participating in the sport of Athletics, for 12 months from the [date of entry], whether or not the licence holder is a citizen of, or resident in, the UK. 

When you become a member of or renew your membership with Cleethorpes Athletics Club you will automatically be registered as a member of England Athletics. We will provide England Athletics with your personal data which they will use to enable access to an online portal for you (called myAthletics). England Athletics will contact you to invite you to sign into and update your MyAthletics portal (which, amongst other things, allows you to set and amend your privacy settings). If you have any questions about the continuing privacy of your personal data when it is shared with England Athletics, please contact dataprotection@englandathletics.org.

I agree with the terms and conditions as described above.

Sorry, we do not offer a refund on membership fees for early resignation or leaving within the membership year

I agree with the refund policy as described above.

To manage this Membership effectively we will need to send you important information by email. We will be providing information that we really need you to see. We will only send you information regarding the Membership itself and will not use your email address for any other purpose.