Hampshire Mountaineering Association 2021 Membership Application
Application form to become a member of The HMA for the year of 2021.
Guest climbers must complete this form to attend a trial meet.
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)
Street Address *
Post Town *
Postal Code *
Phone number *
Optional secondary contact number
Email Address *
Date of birth *
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 *
Contact address *
Contact phone number *
Membership runs for the calendar year:
Adults - January £23, February to August £27, September to December £17
Under 18s/Unemployed/Furloughed - January £18, February to August £20, September to December £13
If you are currently unemployed and in receipt of benefit, furloughed, or partially furloughed use the Under 18 price
Membership Type
Clear selection
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!
Sort code: 30-93-97 Account number: 00633734
Payment must be received within 14 days from completing this form.
Membership postal address: Brett Dale-Heaps, Four Oaks, Reading Road, Hook, RG27 9EB
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 *
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 only use members email addresses for club related communication, and agree to not share or sell them
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?
By submitting this form I accept the agreement above
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy