ARR Application Form | AckworthRoadRunners

Ackworth Road Runners Membership Application Form

Important Notice – Please Read

When you become a member of or renew your membership with Ackworth Road Runners you will automatically be registered as a member of England Athletics. 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).

*Please ensure your email address is correct as it will be used by England Athletics to send your EA membership details.

If you have any questions about the continuing privacy of your personal data when it is shared with England Athletics, please contact dataprotection@englandathletics.org.

Notes:
Please advise of any medical conditions of which the club coaches need to be aware.
Please advise of any change in name, address, e-mail address or telephone number or emergency contact.

About you:

Full name

Title

Gender

Birthday

Day

Month

Year

Email Address

Address

Phone

Are you a member of another UK athletics club?

If "Yes", have you resigned from that club or do you intend resigning from it?

If "Yes", when did you resign?

Will Ackworth Road Runners be your 1st claim club

Do you have any objections to photos of you, or including you, being published on our website or other social media?

Medical Conditions:

Please state below any medical conditions/treatments/disabilities that the Club may need to be aware of? State N/A if there are none.

Emergency Contact Details:

Emergency Contact Name

Emergency Contact Number

Previous running experience:

Please enter your personal best times for the following distances. This is to help us give you a realistic target time if you enter any club handicap events and to place you with appropriate training groups. If you're not sure or if you have not completed some of the distances, please leave blank.

5 miles

10k

10 miles

Half marathon

Marathon

Please give a brief indication of your running experience to date:

Membership:

I hereby apply for membership of Ackworth Road Runners and agree to be bound by the Club Constitution and rules at all times and accept liability for my own safety during training and racing.

Senior (1st claim) £36

2nd Claim (if 1st claim with another EA affiliated club) £25

Concessionary (over 60 with 10 years continuous membership) £28

Student 15-17 (non EA affiliated) £10

Student 15-17 (EA affiliated) £30

Social (not an active runner) £6

Payment:

Please pay by BACS transfer to:

Ackworth Road Runners and AC

Sort code: 05-06-71

Account number: 16040316

Signature

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