Membership Renewal

Name *

First Name

Last Name

Phone *

(###)

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Date of Birth *

MM

DD

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Membership Type *

Full with EA Affiliation - £35

Social / Second Claim - £20

Phone *

(###)

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Club Policies *

I have read and will comply with the club policies.

I agree and will comply with the club policies.

Privacy Statement *

I understand and accept that my data is being passed to the Athletics Governing Bodies and will be processed in accordance with their privacy statement.

I agree and will comply with the privacy statement.

Anti Doping Rules *

I agree to be abide by the UKA Anti Doping Rules

I agree and will comply with the anti doping rules.

Code of Conduct *

I have read and agree to the senior athletes code of conduct.

I agree and will comply with the senior athletes code of conduct.