Bishop’s Stortford Running Club - Membership Form 2016/2017(includes membership of Stortford Tri, our triathlon and multi-sports section)

Personal Details

Please enter / update the information below to allow us to keep our membership database up to date:

Surname (including your Title i.e. Mr, Miss, Mrs)
First name
Address line 1
Address line 2
Address line 3
Postcode
Email address
Home telephone / Mobile
Date of birth / Gender / Male / Female
Occupation
Is BSRC your First Claim Athletic Club?

Membership Fee

The Club’s membership year runs from 1st April to 31st March. Membership fees for 2016-2017 are now due. There is an early payment discount of £5 for existing members renewing before 1st May 2016.

The England Athletics registration fee used to be included in the Club’s membership fee, but for 2016-17this has been separated, with an appropriate reduction of Club membership fee. It is now the member’s option whether or not to join EA and to pay the extra subscription (set by EA, not the Club).

Description / Cost / Tick/subtotal as appropriate
Full Club Membership
(includes £45 for Hockerill Sports & Social Club) / £55
England Athletics affiliation (optional – see below) / £13
Early renewal discount (only applies to existing members renewing before 1st May 2016) / - £5
Total

Payment options are given overleaf, along with declaration/signature section

England Athletics (EA) Affiliation

Personal England Athletics affiliation provides a number of benefits which include primarily a discount when entering EA registered events and entitlement to enter County/Regional/National Championships (some County champs may not require it). Full details of England Athletics and membership benefits can be found at the EA website - Please also note that to be eligibleto enter the Club ballot for any Club places for the 2017 Virgin London marathon, you must be a member of England Athletics (as well as having a current year rejection from the official ballot).

If renewing, you should join England Athletics as soon as possible and preferably before the end of June 2016 which is the end of the grace period given by the EA for renewals. Note thatby opting to join England Athletics you are authorising the Club to disclose your name, address, DOB, email address and mobile phone number to England Athletics.

Mailing Lists

To help the Club keep in touch with you, we operate two email distribution lists and several Facebook pages. Please indicate which mailing lists you wish to join. We strongly recommend you at least join the BSRC list as this is the primary method of communication with members. This is a moderated service and only official Club posts are distributed. The Stortford Tri email group is for discussion of triathlon and multisport related topics, is more informal, and any member can post there. To find our Facebook pages – search for Bishop’s Stortford Running Club (place for general running chat) and Stortford Tri (both an officially managed page and a discussion group exist).

Please add me to the BSRC email listYES / NO

Please add me to theStortford Tri / Multisport email listYES / NO

Payment details

We prefer payment via electronic transfer if possible using the following details, though the form still needs to be completed and returnedto the membership secretary either by email, post or in person:

Account Name: Bishop’s Stortford Running Club

Sort Code: 30-90-84

Account Number: 00844633

IMPORTANT: Please ensure you quote the correct sort code and account number (the account name is not used by the bank) and under Reference provide your SURNAMEAND INITIALS e.g. SMITH A.P. so we can accuratelyrecord your payment.

Alternatively, please return this form together with your membership fee cheque, made payable to ‘Bishop’s Stortford Running Club’, to the address below:

Lorraine Evans,

52 Rainsford Road,

Stansted, Essex,

CM24 8EA

Declaration

By signing below, I declare that I wish to join Bishop’s Stortford Running Club for the 2016-2017 season and agree to abide by Club Rules. I also declare that the Club may store my details provided above for administrative purposes.

I also declare that if I have indicated my desire to join England Athletics, that I agree for my personal details (name, address, DOB and contact details) to be shared with England Athletics.

Signature: ______Date: ______

Enquiries

If you have any questions about membership, please contact the Membership Secretary, Lorraine Evans, by any of the following means:

Email:

Landline:01279 814360 (preferred to mobile, before 10 pm)

Mobile: 07905 404637