2018/19 Membership Application Form
Please complete in BLOCK CAPITALS, and return this form together with payment if required to:
REDDITCH STARS Membership Secretary
By Bank transfer. Sort code 207145 Acc No 63586405.
Name: ...... Title: ......
Address: ......
Postcode: ......
Tel/Mobile: ......
Email: ...... Nationality:......
Date of birth: ...... Gender: Male Female
Have you previously registered with another running club? Yes No
If yes, what is the name of the club? ......
Do you have any health conditions or learning/physical disabilities? Yes No
If yes, please state. ......
Emergency contact name and number(s): ......
FULL membership: This includes UK Athletics affiliation fee of £15 (subsidised by the club to £10) , which entitles you to many benefits including reduced race entry fees, entry into the club draw for a London marathon place and discounts from many sports shops and £60.00 club membership fee Total payment £70.00
BASIC membership: If you do not want the benefits of UK Athletics affiliation £60.00 club membership fee
Notes for all members:
If you are new to running or have not run for a while it is recommended that you visit your GP to check that you are fit for activity. It is expected you are able to run 5km.
We go out as a group, run as a group and return as a group. Please follow the direction of the coach or leader and when directed to do so please loop back to the rear runner. Please follow the direction of the coach or leader at all times. Failure to do so may put you and the group at risk. Failure to follow the direction of coach or leader may result in your membership being terminated.
When running at night you are expected to be visible and be wearing hi-vis clothing as a minimum. Head torches are encouraged.
Speak to the coach/leader about what you wish to get out of the sessions.
By signing and returning this form I understand and accept that:
I am declaring that I am an amateur as defined by the eligibility rule of UK Athletics.
I take part in the club’s activities entirely at my own risk and that I will be responsible for my own safety whilst out running with the club or when I take part in events as a club member.
Personal information will not be disclosed to any party with the exception of England Athletics for affiliation or registering purposes. All athletes will be registered with EA as either 1st claim, 2nd claim or junior.*
I have read the Health & Safety policy, Constitution, Risk Assessments and Byelaws on the Redditch STARS website and agree to abide by these.
Signed: ...... Date: ...... Fee Enclosed: ......