Hampshire Mountaineering Association 2019 Membership Application
Application form to become a member of The HMA for the year of 2019.
Guest climbers must complete this form to attend a trial meet.
Agreement
By submitting this form YOU accept that climbing and mountaineering are activities with a danger of personal injury or death. YOU are aware of and shall accept these risks and wish to participate in these activities voluntarily and shall be responsible for your own actions and involvement.
Personal Details
Full name *
(first name and last name)
Your answer
Address *
(including postcode)
Your answer
Phone number *
Your answer
Optional secondary contact number
Your answer
Email Address *
Your answer
Age *
Your answer
Date of birth *
MM
/
DD
/
YYYY
Emergency Contact Details
Please ensure that your emergency contact is aware that their name, address and phone number will be shared with the committee and meet organisers. This information will only be used in the event of an emergency when your nominated contact needs to be informed.
Contact name *
Your answer
Contact address *
Your answer
Contact phone number *
Your answer
Prices
Membership runs for the calendar year:
Adults - January £17 , February to August £21, September to December £10.50
Under 18s - January £11 , February to August £13, September to December £6.50
Charity Donation: Dorset Bolt Fund
If you wish to make a personal donation to our selected charity; simply pay more than the above prices to The HMA and we will confirm the amount has been donated.

This year we have chosen Dortset Bolt Fund as many of our members regularly benefit from their equipment!
DBF constantly keep a high safety standard up in their area so please use this chance to make a personal donation!

Payment / Guest
When using BACS payment you must put your name as a reference!
Payment must be received within 14 days from completing this form.
Membership postal address: Nadia Ioannou, 35 Walnut Avenue, Chichester, PO19 3EF
Please pick a method of payment *
Privacy / Other
The HMA take the privacy of our members data seriously.

We will only use your data for:
• organising club meets and events,
• the purposes of administration,
• contacting a nominated contact in the event of an emergency.

Only the elected Committee will be able to access your details.
More information about how we look after your data can be found at www.thehma.org.uk/privacy
As a BMC affiliated club, we will provide your name, contact details and date of birth to the BMC to administer your BMC membership, including your combined liability insurance.
The BMC will use your data to communicate with you about your BMC membership.
The BMC will contact you to invite you to create a member profile which, among other things, allows you set and amend your privacy settings.
More information about how the BMC uses data can be found at www.thebmc.co.uk/privacy

We will never share or sell your data without your prior permission.

Privacy *
No
Yes
I consent to my email address being shared with other members attending the same meet as me (to facilitate meet organisation eg. transport arrangements)
I will not pass on or sell any members email addresses that have been shared with me, and will only use them for club related communication
I understand that any club equipment that I may borrow I use at my own risk and that any such equipment is provided without any warranty about its condition or suitability
I consent to any photos of me at club events being published on any HMA media (HMA website and facebook)
How did you find out about the club?
Your answer
By submitting this form I accept the agreement above
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