Steel City Striders Running Club Membership Application Form
Applicant Information
Forename(s):
Surname:
Gender:
Address:
Postcode:
Date of birth: / City of birth:
Landline number: / Mobile number:
Email address:
Application Type
New member or renewal:
Membership number (for renewals, if known):
Are you a first claim member of, or have been a member of any other athletic club? (Please give as much detail as possible, joining/leaving dates etc):
Payment Type (tick appropriate option)
Cheque: / Bank transfer: / Paypal:
Emergency Contact
Name:
Telephone:
Relationship:
Running History
Please give a brief history of your running. How long have you been running, distances, PBs etc to help us tailor training sessions? (Please give as much detail as possible)
Skills
Do you have any skills that you would be willing to volunteer to the club? (IT, coaching, admin, accounting, first aid or anything you feel coud be useful?)
Striders Vest for New Members choosing “with vest” option (tick requested size)
Mens Small, 36 inch [ ] / Ladies 8 / XS, 32 inch [ ]
Mens Medium, 38 inch [ ] / Ladies 10 / Small, 34 inch [ ]
Mens Large, 40 inch [ ] / Ladies 12 / Medium, 36 inch [ ]
Mens XL, 42 inch [ ] / Ladies 14 Large, 38 inch [ ]
Mens XXL, 44 inch [ ] / Ladies 16 / XL, 40 inch [ ]
Declaration
I agree that I am an amateur as defined by England Athletics. I agree to abide by the rules and conditions of membership as laid down by the Committee of the Club and I agree to abide by the Laws of England Athletics and any other Association to which the Club is affiliated.
I agree that the Club will in no way be held responsible for any injury or illness incurred to my person during or as a result of my participation in club events.
I agree that the Club will retain a computer record of the personal data, which I have provided on this form.
Tick here to disagree. [ ]
Signature of applicant: / Date:
Please send completed form and cheque payable to ‘Steel City Striders’ (if paying by that method) to:
Striders Membership Secretary, Stewart Robinson, 322 Edmund Road, Sheffield, S2 4EN.