Membership Application and Renewal Form

Membership Application and Renewal Form

Valid to 31 March 2018

Please enter ALL details, sign & date the form and post with a SAE and cheque payable to ‘Hardley Runners’ to the Membership Secretary below.

Membership Fees: The annual membership fee for Runners aged 21 and over is £15 per person (£5 Out of County).

Youths aged 15 to 20 are free. Minimum membership age is 15 years. We do not cater for junior members and we recommend people under 15 to join New Forest Juniors AC (see http://www.newforestjuniors.co.uk/ ).

There is no charge for new members joining between Jan 1st and Mar 31st.

Social membership is available for adults who wish to participate only in the social aspects of the club at £5 per couple or single member. There is no charge for non-running spouses and partners of Running or Social members who are very welcome at social events and/or in support of running events.

England Athletics membership: NB: You do not require EA membership to compete in club, RR10 or CC6 events.

EA membership provides a discount (£2 minimum but more for some races) on entry fees for ‘Open’ road and off road races. You MUST be EA affiliated if you wish to enter County, Southern and National events promoted under EA rules including Hampshire Cross Country League races. If you wish to be affiliated to England Athletics there is an extra charge of £14.50 per member. If you pay EA fees through another Club then you do not pay twice; just put ‘No’ in the EA box. If you affiliated to EA last year please include your personal membership number in the EA number box below.

If you are a member of another EA Club please enter details and show whether the other Club is your 1st Claim club.

Runners aged 21 and over (£15 each or £5 each Out of County) / Number: /

Amount

/ £
Members needing EA registration (£14.50 each in addition to above) / Number: /

Amount

/ £
Social members (£5 per couple or single member) /

Amount

/ £

Total amount enclosed (cheques payable to Hardley Runners) – insert amount

/ £
Surname / Forename / M/F / EA
Yes/No / EA number / Date of Birth DD/MM/YY / Name of other EA club / 1st Claim
Yes/No
1
2
3
4

Contact Information

Home Tel No / Work Tel No / Mobile Tel No / Email
1
2
3
4

Correspondence address – only one per family please:

Line 1 / Please put an X in this box if you would like a car sticker
Line 2
Line 3
Line 4
Post Code

I/We undertake to participate in all Club events at my/our own risk and will not hold the club or its officers responsible for any loss, damage, injury or any other matters which might arise. The responsibility for members between 15 and 18 years of age remains solely with their parents/guardians or their representative/s who must be nominated in writing. This applies to training sessions, races and social activities. The data on this form will be stored on computer and will only be passed to UKA bodies for official purposes.

PLEASE NOTE: Club membership cards will only be issued on receipt of a completed membership form and a stamped addressed envelope. Your card will entitle you to a discount at most running equipment shops.

Signed:
Note ALL members to sign please / Date

Please return with a STAMPED ADDRESSED ENVELOPE to:

Kim Wainwright, 127 Beech Crescent, Hythe, Southampton, Hampshire, SO45 3QE
e-mail: tel: 02380 843883