Membership Form

SECTION A: ATHLETE DETAILS

First Name Required

Surname Required

Gender Required

Gender at birth (Required by EA) Required

Address Required

Postcode Required

Telephone

Mobile Number

Date of Birth Required

Email Required

Are you a member of any other sports club? Required

Yes

If yes, which club and which sport?

Country of Birth Required

Type of Membership Required

SECTION B: MEDICAL INFORMATION

Please detail below any important medical information that our coaches should be aware of (e.g. epilepsy, asthma, diabetes, allergies etc.) Please do not leave blank – if there is no information please write ‘None’.

Medical Information Required

SECTION C: EMERGENCY CONTACT DETAILS

Please insert the information below to indicate the persons who should be contacted in event of an incident/accident

Emergency Contact Name Required

Emergency Contact Number Required

It may be essential at some time for authorised persons acting on behalf of the club to have the necessary authority to obtain urgent treatment which may be required whilst at representative club competition or training.

SECTION D: ATHLETE AGREEMENT AND PAYMENT

Club Code of Conduct

By returning this completed form, I am willing to abide by the club code of conduct for athletes and agree to always behave in the manner befitting a DH Runner, when attending club events. Club Code of Conduct can be read in the above link Required

In becoming a member of DH Runners, DH Runners and England Athletics will collect certain information about you which will include your name, date of birth, gender, email address, address, telephone number, names of other sports clubs that you are a member of, country of birth, medical conditions and emergency contact details. This information will not be shared with any other parties.

Type your name to agree Required

We look forward to welcoming you and your family to the club in the near future.

Please click Submit below to send your details to the club, you will receive an email in the next few days from England Athletics requesting payment