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Do you wish to join FODAC as 1st-claim club? YES / NO (DELETE)

Membership is available on an individual or family basis

Please, indicate which type of membership is required.

Membership is renewable on 1st Aprileach year

Surname / Training / Training & Competitive
Forenames / (delete as applicable)
Title / Date of Birth
Address
Postcode / Telephone Number
Email Address * / Mobile Number *

* Minimum of one of these needed

If applying for Family Membership, please list AdditionalMembers here:-

Name

/

Male/Female

/

Date of Birth

/

Training or Training & Competitive

/

Office Use OnlyE.A Number

We ask all members and parents to help out at club events for a few hours each year.
Are you willing to do so? YES / NO. (If YES, someone from the Club will contact you to explain more about the options available.)

JUNIORS ONLY. We have a Text Service only to be used for occasional, urgent messages e.g. Training cancelled due to poor weather.All other general messages will continue to be sent by email and put on the Junior website.

If you wouldlike to OPT INto the Text service, please tick here:

FEES
In addition to Club fees, athletes can choose to pay a fee to England Athletics which gives a number of additional benefits, including reduced race fees. It also allows the athlete to represent FODAC in Team Events such as cross country, track & field and Sportshall. This fee is payable for ANY competing athlete over 11, including Family and Life Members.

CLUB FEES (TRAINING ONLY MEMBERSHIPS) / Fee Due / Number of athletes / Total Amount
(Fee x number)
Under 18 and full time students / £10.00
Over 18 / £15.00
Family Membership / £30.00 / N/A
Life members / Officials / Helpers / Free / NIL
EA AFFILIATION FEES (COMPETITIVE)
U11 (Born AFTER 31/8/2006) / Free / NIL
Over 11 on 1/9/2017 / £14.00
TOTAL / £

Please make cheques payable to Forest of Dean AC. Cash to be put in a sealed envelope with the forms and placed in the membership box in the Club Hut.

Forest of Dean AC is a registered charity. If the person paying the CLUB fees is a UK Taxpayer, Gift Aid may be reclaimed for the benefit of the club. To agree to this, please complete a “Gift Aid” form and return it with your membership application.

By returning this completed form, I agree that I have read and agree to abide by the Club Code of Conduct for athletes and agree to always behave in the manner befitting a Forest of Dean AC Athlete, whenever I am present at Club activities or competition. (Club policies available on website or in Club Hut) TICK BOX

Under 18’sBy returning this completed form, as a parent/guardian I agree to the named athlete(s) taking part in the activities of the club.

ALL MEMBERSHIP MUST BE ACCOMPANIED BY A COMPLETED MEDICAL FORM FOR EACH MEMBER OTHERWISE MEMBERSHIP WILL NOT BE ACCEPTED.

I enclose the appropriate membership fee

Signature
Print Name

Date______

Please return your completed forms to

Cherry Fowler, Ingleside, Main Road, Yorkley, NrLydney GL15 4TR

Or box in Club Hut.