NEWTON ABBOT

I wish to apply for membership of Newton Abbot A.C. (Open to all minimum age 8 years)

If accepted I agree to abide by the Rules of the Club and of the Governing Body.
All competitions under the Rules of the Governing Body are confined to amateurs who abide by the eligibility rules of the Governing Body.

FULL NAME*

DATE OF BIRTH*

Address*

Street Address

Street Address Line 2

CityCounty

Post Code

TEL NO*

E mail *

example@example.com

Secondary Emergency Contact Name and Number.*

Additional information

Any other details that you feel we should be aware of ie, Asthma, Allergies, any special educational needs.

CODES OF CONDUCT*

	YES	NO
I/we have read and agree to comply with the clubs codes of conduct
I consent to any emergency treatment required by myself/my child whilst under the supervision of the club.
I confirm that I am/my child is in good health and myself/my child is fit to participate and will disclose any health issues that arise.
Are you happy to have your child's (unnamed) photo on any media or promotional material?

Codes of Conduct Can Be Found Here

ANNUAL MEMBERSHIP FEE

Students/Juniors - £34.00 (inc. EA fee of £19) Seniors: £49.00 (inc. EA fee of £19) Juniors under 11 (years 3,4,5) £15.
Payment by BACS Payments - Santander, sort code 090153, a/c no. 28885487,
Newton Abbot Athletics Club, ref - child's name

NOTE : Please be aware that video recording may be used as a coaching/training aid.

16+/ Parent/ Guardian Signature

Date

Chairman's signature OFFICIAL USE ONLY:
When you become a member of or renew your membership with Newton Abbot Athletic Club you will automatically be registered as a member of England Athletics - in all the age groups above except the Juniors under 11..
We will provide England Athletics with your personal data which they will use to enable access to an online portal for you called (My Athletics England) Athletics will contact you to invite you to sign into and update your My Athletics portal which, amongst other things, allows you to set and amend your privacy settings If you have any questions about the continuing privacy of your personal data when it is shared with England Athletics.
please contact dotaprotection@englandathletics.org

Chairman's Signature

Date

MEMBERSHIP FORM