Membership Form-2

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HONITON RUNNING CLUB MEMBERSHIP FORM

Membership is open to all groups of the community

(Club colours Black, Red, White)

New Membership Fees (April 2018 - March 2019)

Full Membership including registration with EA and a vest - £35
Full without EA registration including a vest - £20
Family Membership - £37.50 (+£15 each for family members requiring EA registration and £5 per vest)
Student Membership with EA - £30 Student without EA (including vest) - £15
Associate Membership (non-running) - £5

Note: registration with England Athletics (EA) enables you to have a reduced entry fee for EA events. We have to send EA basic contact details to register you.
If you are already registered with EA through another club you do not need to do so again and save £15. If you join after 1st October the fees are reduce by £7.50.

How to Pay for Online Membership

1. By bank transfer (BACS)
The Honiton RC account details are
Account Name: Honiton Running Club
Account No: 91367757
Sort Code: 40-24-28

2. Give cash or cheque to "Honiton Running Club" in sealed envelope,with your name, the amount and what the money is for written on it, to a club official

HONITON RUNNING CLUB MEMBERSHIP FORM

* Indicates required field

Family Name *

Forenames (Underline preferred name) *

Gender *

Male Female

Address1 *

Address2 *

Town *

County *

Post Code *

Tel. No. (Day) *

Tel. No (Home) *

Mobile *

Email *

Date of Birth *

Emergency Contact Name *

Emergency Contact Tel No. *

GP Name *

GP Tel No. *

Please indicate here, any personal health issues which may be adversely affected by running. (Alternatively you may discuss the matter in private with a club official).

Health issues *

Are you a member of another club? *

Yes No

Name of Club *

Membership Required *

Full Family Student Associate

Do you require England Athletics registration? *

Yes No

I the above named, wish to become a member of Honiton Running Club.
Payment to be made either online using BACS (see above), or by cheque in sealed envelope with name and amount enclosed recorded and given to club official.
Please make cheques payable to “Honiton Running Club.”
I declare that I am physically fit and able to partake in sporting activity. I also agree to abide by the club rules (copy here). Please note. If you have any physical condition or ailment which might be adversely affected by strenuous physical activity, consult your G.P. before taking part.

Signed (typed signature is acceptable) *

Date *

How will you pay - BACS or by cheque/cash? (see above) *

ADDITIONAL INFORMATION

How would you describe yourself? *

Beginner Slow runner/jogger An average runner A faster runner - better than 7:30 min/mile pace

Main reason for joining the club (tick any that apply) *

To improve health and fitness I enjoy running with other people and the social side of the sport I want to improve so I can take part in running events I am interested in competitive running and want to improve

Qualifications

Please let us know of any qualifications or experience that you have that may be useful to the club

Engalnd Athletics coaching qualification *

Yes No

Do you hold a current EA coaching licence?

EA Details *

Current CRB check *

Yes No

CRB Details *

1st Aid qualification *

Yes No

1st Aid Details *

Race official qualification *

Yes No

Do you have any EA Road Race Official qualification?

Race Official Details *

Any other qualifications or skills that may be useful to the club *

Yes No

Other skills details *

Have you ever been a member of other running clubs or athletics clubs? *

Yes No

Other Club Details *

Have you every been involved in the organisation of a running club or a running event? *

Yes No

Club Organisation Details *

Data Privacy

When you renew your membership of Honiton Running Club our policy on keeping your data can be read here
Also when you become a member of or renew your membership with Honiton Running Club you can also choose to be registered as a member of England Athletics (you will have to register with England Athletics if you ever compete for the club in competition Under UKA Rules). If you select 'Yes' in the box above 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 [email protected].

I agree that Honiton Running Club can store my data for 4 years from when I join unless I ask for it to be deleted *

Please answer yes or No

Please keep me in touch with HRC via email group *

Vest size

Vest size *

Small Medium Large

Ask Judy Davy for a vest when you join.

Submit