WARE JOGGERS Application for Membership / Renewal, including England Athletics Affiliation. Covering period April 1st 2008 - March 31st 2009
Personal Details
First Name	A value is required.Minimum number of characters not met.
Surname	A value is required.Minimum number of characters not met.
Date of Birth	Day A value is required.Minimum number of characters not met.Exceeded maximum number of characters. Month A value is required.Minimum number of characters not met. Year A value is required.Minimum number of characters not met.                         Gender Male Female
Contact Details
House Number, Street	A value is required.Minimum number of characters not met.
Address con' t	A value is required.
Town / City	A value is required.Minimum number of characters not met.
County	A value is required.Minimum number of characters not met.
Post Code	A value is required.Minimum number of characters not met.
Home Telephone	A value is required.
Mobile Telephone	A value is required.
Email	A value is required.Invalid format.
Club Status: please tick what status the athlete is to the club
First Claim Second Claim		Higher Competitor	Foreign Athlete
Volunteer Status: please tick what status the athlete is to the club
Club Officer	Helper	Coach	Technical Officer

Membership of Ware Joggers (£5.00)    Individual Affiliation to England Athletics (£5.00)   Total payment - £5.00 or £10.00

Payment amount enclosed:     £5    £10             Please select either:    Cash Cheque

Declaration:
I have read the Club Rules, which are displayed on the notice boards and agree to abide by them.

I understand the nature of the Club and I am medically fit to run.

I agree that I can take part in any Club activities or events at my own risk and take full responsibility for my safety and actions.

The club, its officers and members will not be held responsible for any injury, illness or accident to my person, or loss or damage to my property as a result of my participation in any Club activities or events.

I Do Do not want my name and telephone number to be included in the Club Members contact list.

Signed .....................................................................    Date: Day A value is required.Minimum number of characters not met. Month A value is required.Minimum number of characters not met. Year  A value is required.Minimum number of characters not met. 

Please return this form with the appropriate payment to Babara Oakley, Members Rep, at any Club session.

Data provided on this form will be stored on a database managed on behalf of Ware Joggers by the club secretary and England Athletics by Athlete Services. Personal contact information will be used to send a competition / membership card and seek appropriate data clearences.