Youghal Athletic Club Membership Registration Form

Youghal Athletic Club - Registration Form

Complete the form below to request 2025 membership.
Please select Type of Application*
2025 Fees:

Adult (Senior/Masters) €60

Juvenile (x1) €40 Juvenile (x2) €70 Juvenile (x3) €95

Students (Juniors) / & Unemployed €40

Family (max 5) €180

(Various multiple member discounts are applied and shown in total price below)

PLEASE NOTE ONLY JUVENILES BORN ON OR BEFORE 2017 (U8') ARE ELIGIBLE FOR REGISTRATION IN 2025. UNFORTUNATELY WE CANNOT ACCEPT YOUNGER MEMBERS
Name 1*

First NameLast Name
Name 2*

First NameLast Name
Name 3*

First NameLast Name
Name 4*

First NameLast Name
Name 5*

First NameLast Name
E-mail 1*

Confirmation Email(of Parent if athlete is under 16)
E-mail 2*

Confirmation Email(of Parent if athlete is under 16)
Phone Number 1:*

Area CodePhone Number (of Parent if athlete is under 16)
Phone Number 2:*

Area CodePhone Number
Emergency Contact No:*

Area CodePhone Number
Address:*

Address Line1

Address Line 2

TownCounty

Postal Code
Birth Date 1:*

DayMonthYear
Birth Date 2:*

DayMonthYear
Birth Date 3:*

DayMonthYear
Birth Date 4:*

DayMonthYear
Birth Date 5:*

DayMonthYear
Interests*

Road RunningTrack & FieldCross CountrySocial Events
Feedback
If you have any suggestions, comments or complaints, please add them below. All feedback is appreciated in helping us make this club even better.
Membership Rules
I agree to abide by the rules of Youghal AC
We agree to abide by the rules of Youghal AC
I agree to abide by the rules of AAI
We agree to abide by the rules of AAI
Code of Conduct

https://www.athleticsireland.ie/downloads/other/AAI_Code_of_Conduct_for_Young_Athletes.pdf
I / We have read the AAI Code of Conduct (link above) and agree to abide by same*

Yes
Privacy Policy

You can access the Athletics Ireland Privacy Policy and Privacy Statement at http://www.athleticsireland.ie/about/gdpr/ Club membership forms are held by the Club for 1 year prior to being destroyed. Membership data is stored for three years on the Athletics Ireland membership database before being securely deleted. If you have any questions about the continuing privacy of your personal data when it is shared with Athletics Ireland, please contact dataprotection@athleticsireland.ie
I agree to receive e-mails and texts from Youghal AC relaying club news and information. http://www.athleticsireland.ie/clubs/gdpr
We agree to receive e-mails and texts from Youghal AC relaying club news and information. http://www.athleticsireland.ie/clubs/gdpr
Photo Release

The Athletics Ireland photography policy is available on www.athleticsireland.ie. As far as is possible the club will not allow photographs, video or other images of children/young people to be published without the consent of the parents/carers and children/young people.
I hereby grant Youghal AC permission to use my image in good taste in promotional materials, posters, Web sites and other merchandise. I release Youghal AC from all liability of any nature in the use of any electronic or film image and or audio for advertising purposes. http://www.athleticsireland.ie/clubs/gdpr*

YesNo
We hereby grant Youghal AC permission to use our image in good taste in promotional materials, posters, Web sites and other merchandise. We release Youghal AC from all liability of any nature in the use of any electronic or film image and or audio for advertising purposes. http://www.athleticsireland.ie/clubs/gdpr*

YesNo
Medical Fitness
I am fully informed and aware that running and participating in club activities, including volunteering, are potentially hazardous. I understand I should not participate in any group activities (sanctioned or unsanctioned) unless I am medically fit and able to safely participate. I acknowledge it is my sole responsibility to ensure my level of medical fitness and do hereby declare that I am medically fit.
We are fully informed and aware that running and participating in club activities, including volunteering, are potentially hazardous. We understand we should not participate in any group activities (sanctioned or unsanctioned) unless we are medically fit and able to safely participate. We acknowledge it is our sole responsibility to ensure our level of medical fitness and do hereby declare that we are medically fit.
If your child has any special requirements or needs please make the club coaches aware
In the event of illness or accident, having parental responsibility, I give permission for medical treatment to be administered where necessary by a nominated first aider, or by a qualified medical person. If I cannot be contacted and my child needs emergency treatment, I authorise a qualified medical practitioner to provide emergency treatment or medication*

YesNo
Payment Details
Fee (€)

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Youghal Athletic Club - Registration Form

Feedback

Membership Rules

Code of Conduct

Privacy Policy

Photo Release

Medical Fitness

Payment Details