Membership Application
Form for 2017/2018
Membership of Ilkley Harriers is open to all members of the community. Membership runs from
1st October 2017 to 30th September 2018 and entitles you to newsletters, social events, training and racing with the Club. It includes affiliation to England Athletics (EA) and access to our base - Ilkley Lawn Tennis & Squash Club (ILT&SC) on Tuesday nights. We hold certain information about you. We use this information for membership lists distributed to members only.Some of this information is passed to ILT&SC and to EA.
Membership Fees 2017/2018Please tick box that applies:
First-claim members
Individual - one adult (18 and over) £34 □
Joint - two adults (18 and over, unless student) joining at the same time & living at the same address, £60 □Please state joint member’s name …………………………………...(NB Separate form required for each person)
16-18 years, or student in full time education £14□
Second-claim members (i.e. for those already a member of an alternative athletics club)
Individual £20□ Please state club. ……………………………………………
Joint £32□ and UKA No.(s) ……………………………………………
If the membership fee is financially difficult, please contact the Membership Secretary or committee member.
Title
First Name
Surname
Address
Post codeDate of birth
Contact Telephone No:
Emergency telephoneNo:
I agree to receive e-mail communications from Ilkley Harriers? YES/NO
I confirm that the above details are correct. By applying for membership I am aware that I am agreeing to comply with Ilkley Harriers’ policies, procedures and codes of practice. I understand that the information about me will be held on a computerised system and do not object to this.
Signed……………………………………………………….Date……………………………………………………
I have made a bank transfer / I enclose a cheque (delete as appropriate)
NB- If under 18, parent or guardian to sign & please ensure you enclose a completed Parental Consent form with your membership application
Please check that you have completed all your details and return this formto:
Membership Secretary, 29 St Philip’s Way, Burley in Wharfedale, LS29 7EW,
or email to
Payment: by bank transfer (strongly preferred): sort code 05-05-30 account 35042481 (please enter your surname in reference box), or by cheque payable to ‘Ilkley Harriers’.