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Ackworth Road Runners: Membership Form
Full Name
Title
Gender
Date of Birth
Email
Phone
Street Address
Street Address Line 2
City
Post code
Are you a member of another Club
*
Yes
No
Do you object to any photos of, or including you, being published on our web site or other social media
*
Yes
No
Emergency Contact Name
If "Yes" please supply details
Please state any medical conditions/treatments or disabilities that the Club should be aware of?
Phone No.
Race Experience
None
parkrun
5 miles
10k
10 miles
Half Mar
Marathon
In order for us to help with your training, please state your personal best times for the race distances you have ticked above. If none do you currently run, if so how often and what distances
Select Membership Fee
Application Date
*
required
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.
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
Payment
Submit Application
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