Membership Application – Shelton Striders Running Club

Names: *

First

Last

Date of Birth: *

Sex: *

Address: *

Post Code: *

Email (If under 18, please state a parent/guardians email): *

Confirm Email

Home Phone Number: *

Mobile Phone Number:

Emergency Contact Information - Contact Person 1: *

Emergency Contact Information - Contact Person 2:

Membership Status: *

First Claim / Previous Club (if applicable):

Please state the name of your first claim running club. If joining from another club, please state previous club and the date of leaving.

Parent/Guardian Consent (Under 18s only):

Please tick if you are the parent or guardian of the person named in the application, and enter your details in the field below.

Parent/Guardian Details (if ticked above):

Payment: *

(please tick to agree) A payment request will be emailed to you, once we have verified and processed your form.

(Please see the 'Membership Details' page for fees)

Declaration and Disclaimer: *

(please tick to agree to the statement) We use the England Athletics' web portal to administer membership data and collect renewals for all members whether they opt for EA registration or not. England Athletics will use your data 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). I agree to abide by the rules and regulations of the Shelton Striders and of England Athletics and acknowledge the use of my personal data for club administration in accordance with the club and EA data protection policies. I understand that I am responsible for my own health and fitness and run at my own risk, and that Shelton Striders, coaches/leaders/members shall not be liable for any loss, injury or damage arising out of my participation.

UK Anti-Doping Rules *

(please tick to agree) I am also aware of and agree to be bound by the UK Anti-Doping Rules and have agreed to sign up to the Senior Athletes Code of Conduct. https://www.englandathletics.org/clubhub/resource/senior-athletes-code-of-conduct/