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Membership application - Individual 0308

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					WIMBORNE ATHLETIC CLUB                                                                                                WIMBORNE ATHLETIC CLUB
   MEMBERSHIP APPLICATION (INDIVIDUAL)                                                                                  CONDITIONS OF MEMBERSHIP

                                                                                                     I hereby agree and declare:-
Name (in full): ……………………………………………………………………………………
                                                                                                        a)   That I will only train and take part in any activities for the Club, and
Address (in full): ………………………………………………………………………………...                                                    compete in competitions for the Club as a member, when I am physically fit to
                                                                                                        do so and I am not suffering from any injury, illness or allergy in respect of
…………………………………………………………………………………………………….                                                                 which physical activity would be harmful to my health.

e-mail (if applicable): …………………………………………………………………………….                                                  b)   That I will inform an official of the Club of any injury, illness or allergy as
                                                                                                        mentioned in a) above.
Telephone No.: ………………………………… Date of Birth: ……..…………………...
                                                                                                        c)    When I am competing for the Club or attending any Club activity or
                                                                                                        competition, including League competitions, I will at all times remain within the
Are you a member, or have you been a member, of any other Athletic Club within the
                                                                                                        confines of the stadium, athletic track or other venue unless I am specifically
                                                                                                        authorised by a Club official to do otherwise.
last three years? *YES/NO             If Yes, which Club? ……………………………………….
                           st   nd                                                                      d)    That I will abide by the UK Athletics Rules for Competition.
Are you applying for 1 or 2          Claim Membership?      *FIRST / SECOND

I hereby declare that I am an amateur and am eligible to compete under the Rules of
UK Athletics.

The information given above is correct and I agree to abide by the conditions overleaf.              Every athletic club and athletic meeting is supported by many voluntary helpers
                                                                                                     and officials. Whilst we hope that you will compete for the Club, you may feel that
I am applying for membership and enclose the sum of £ …………, being my Annual                          your talents lie in judging, timekeeping, starting or in general Club administration.
Subscription in full for the current year. (Cheques payable to: Wimborne Athletic Club)
                                                                                                     You will be made just as welcome and any Committee member will be happy to
                                                                                                     provide details.

Signature: ……………………………………..………..….. Date: ……….…………..……..

**************************************************************************************************
UNDER 16 – Parent/Guardian                                                                           PLEASE RETURN YOUR COMPLETED APPLICATION FORM TO OUR
By returning this completed form I give my consent for the child in my care to join                  MEMBERSHIP SECRETARY:
Wimborne Athletic Club and take part in the activities of the Club and agree he/she will
abide by the conditions overleaf.                                                                                      Mr R P Nunn
                                                                                                                       9 Oakley Road
                                                                                                                       Wimborne
Parent/Guardian Signature: …………………………………………………………………...                                                                Dorset BH21 1QJ                       Tel: (01202) 888793

                                                                                                     PLEASE NOTE:
Name: …………………………………………………………….                                           (For contact in need.)      All applications are subject to approval by the Executive Committee of Wimborne
                                                                                                     Athletic Club.
                                                                                                     Persons of either sex are eligible for membership of the Club and no person will be
Date: ………………………. School Attended: ………………..……………………………                                                denied membership of the Club on the grounds of race, ethnic origin, creed, colour,
                                                                                                     age, disability, sex, occupation, sexual orientation, religion, political or other
(* Delete as applicable)                                                                    03/08    beliefs.