Gosport Road Runners 2024/25 Membership Application
To apply for membership please carefully complete all questions.
Name
*
Mr.
Mrs.
Miss.
Ms.
Dr.
Rev.
Prefix
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
County
Post Code
Date of Birth
*
-
Day
-
Month
Year
Date
Email Address
*
example@example.com
Home Number
-
Area Code
Phone Number
Mobile Number
-
Area Code
Phone Number
Emergency Contact
*
First Name
Last Name
Emergency Contact phone Number
*
-
Area Code
Phone Number
Previous Running Experience
Membership Fees
Membership type: Unaffiliated £27 Affiliated £37 The easiest (and preferred) way to pay your membership fee is via Bank Transfer (Please state your initial & surname in the payment reference) Sort Code: 30-93-56 Account Number: 00586779 If you affiliate after renewing, you will be liable for the full £19, honorary members also pay the full £19. Discount only applies at time of registration.
Affiliation information
When you become a member of or renew your membership with Gosport Road Runners you can also choose to be registered as a member of England Athletics (Affiliated) (you will have to register with England Athletics if you ever compete for the club in competition Under UKA Rules). If you tick the box below we will provide England Athletics with your personal data which they will use to enable access to an online portal for you (called myAthletics). England Athletics will contact you to invite you to sign into and update your MyAthletics 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 dataprotection@englandathletics.org.
I wish to affiliate to England Athletics & understand you will share my information to create an account.
Yes
No
Please Note
Your personal details are solely for use within Gosport Road Runners & will not be shared with 3rd parties.
I would like to receive a monthly newsletter from Gosport Road Runners and to be kept up to date with relevant information
Yes
No
Please indicate if you wish to be contacted by Gosport Road Runners
Yes
No
Please indicate your method of payment.
Membership renewal / New Joiner Affiliated - Bank Transfer £37
Membership renewal / New Joiner Unaffiliated - Bank Transfer £27
Honorary Member Unaffiliated - £0
UKA Affiliation Fees
Honorary members - Bank Transfer £19
Signature
*
(Please Click in the signature box hold your left mouse button down and sign your name)
Signature Date
*
-
Day
-
Month
Year
Date
Submit
Should be Empty: