Cumberland AC new member on-line application form
             
Individual membership is £10, family membership is £15. Cheques payable to Cumberland AC.    
             
Personal details          
Surname:   First name(s):    
Title:          
Gender:   Date of birth:    
             
Address line 1:    
Address line 2:    
Address line 3:    
County:   Post code:    
             
Home phone no:   Work phone no:    
Mobile phone no:   Fax no:    
             
e-mail address:      
             
Membership of other clubs          
Other clubs of which you are a member:  
Status - first claim / second claim:  
Date of resignation from previous club:      

Disciplines in which you expect to compete

 


     
Cross country: Fell & hill: Race walking: Road running: Track & field
Volunteer role          
Timekeeper: Track judge: Field judge: Starter: Marksman: Ancillary:
Coach level qualifications          
Level:   Events:    
             

I confirm that I am eligible to compete under UK Athletics Rules.

I accept that my personal data will be held on a computer by the club.

I agree to the disclosure of my personal data in a list of members and to the North of England AA.

             

             

Completion Notes

The “Application for Membership” form is a comprehensive document designed by the North of England Athletic Association and is intended to deliver data on the level of participation in our sport.

 You may find that you cannot provide data in all sections of the form e.g., you may not have been a member of another club or posses coaching qualifications.  This is expected and is not a problem so long as you complete as much of the form as you can.

Membership of other clubs - give details of other clubs of which you are a member, and state whether you are a 1st or 2nd claim member of that club.

Discipline Participation – tick the box(es) for the disciplines in which you wish to partake.

Volunteer Role – tick the box(es) for any role you wish to fulfil.

When completed hit the submit form button; this will e-mail the completed form to the Cumberland AC  membership secretary.

Bring your cheque to your first Club meeting / training evening, and give to a Club commitee member.

Or. print form, and return (with your cheque, payable to Cumberland AC, for £10 individual membership or £15 family membership) to the membership secretary:

Mr Shaun Cavanagh, 15 Ismay Wharf, Maryport, Cumbria, CA15 8AX