Membership Form

First, choose your membership type*

*Please refer to the membership type descriptions on the previous page.

—Please choose an option—First Claim: Senior men and Women - £41 Paypal, £40 BACSFirst Claim: Juniors, Unwaged, Retired, Students - £36 Paypal, £35 BACSSecond Claim - £26 Paypal, £25 BACSFirst Claim: Other - £26 Paypal, £25 BACSFirst Claim: Transfer - £26 Paypal, £25 BACSAssociates: £26 Paypal, £25 BACS

If paying by Paypal there is £1 Surcharge to cover fees.

Personal Details

Your First Name (required)

Your Last Name (required)

Your Email (required)

Telephone Number (required)

House number and Street

Address line 2

City

Postcode

Date of Birth: (In Format dd/mm/yyyy)

Ethnicity and Diversity

Ethnicity: White (UK)BlackIndianPakistaniBangladeshiIndianChineseBlack (UK)Black (Caribbean)Black (UK)Black (African)BangladeshiNot DeclaredWhite (Non European)White (European)

Gender at Birth: MaleFemale

Do you have a disablity?: NoYes

Medical Conditions

Do you have any medical conditions: NoYes

Emergency Contact Details

Name of emergency contact (required)

Telephone Number (required)

Coaches and Officials

Please show below any accredited Coaching Courses or Officials Licence issued by UK or England Athletics. Do you hold an Enhanced DBS certificate issued by UK Athletics? If so, please state certificate number and date of issue.

Anything else you would like to tell us about?

The Legal Stuff

Membership Terms and Conditions Privacy Policy

When you become a member of or renew your membership with Sheffield Running Club you will automatically be registered as a member of England Athletics. We will provide England Athletics with your personal data which they will use to enable access to an online portal for you (called myAthletics portal). England Athletics will contact you to invite you to sign into and update your profile on the 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 hereby consent to the taking of images by an authorised person at any club training session or any competition or league event permitted by the sport’s governing body.

Please select if you paying by Paypal or BACS/Bank transfer

—Please choose an option—PaypalBACS