JUNIOR (Under 16) Membership

Please enter information on the form below to process subscription for JUNIOR (Under 16).

Email *

Password*

Retype Password *

First Name *

Last Name *

Address *

Address2

Town *

Post Code *

Phone *

Date of Birth *

Under 18 *

Yes

Parent / Guardian *

Emergency Tel *

Gender *

Male

Female

Medical Conditions *

Heart Disease

Epilepsy

Asthma

Diabetes

Any allergic reactions

None

Declaration

From time to time we may want to use your name and/or photograph on the club website, club newsletter, local newspapers or club promotional material. Please choose 'Yes' below if you agree for us to use the above information and 'No' if you do not want to be included in any publications.

Confirm *

Yes

Payment Information

Price

Payment Fee

Gross Amount

Payment Method

Credit / Debit Card

Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Holder Name*

By accepting the privacy policy below, you are agreeing to comply with the rules of the club, UK Athletics and Welsh Athletics (where appropriate) and participate in activities entirely at your own risk.

I have read and agree to the Privacy Policy

JUNIOR (Under 16) Membership

Existing User? Please login

New User? Please register

Declaration

Payment Information