Membership information
November 2021- October 2022 (to be completed by Parent/Guardian if member is under 18)
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Email *
Name *
Address *
Phone number *
Medical Conditions - Please disclose any and all medical conditions; if none please write none *
ICE Name
ICE Contact Number *
I give permission for South Shields Tri and any affiliated party to use my data and store it electronically. *
I give permission to South Shields Tri to use photographic or video images. *
Medical Consent- I give consent that should urgent medical or surgical treatment is required it can be given. *
Membership fee payment method Adult £25 Junior £5 Family £45
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