Mote Runners Membership Form
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Title *
Firstname *
Surname *
Date of Birth *
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Email *
Telephone *
Address *
Postcode *
Second Claim
*second claim members only 
*please state the name of your first claim club
Membership *
Sex at Birth 
If registering with England Athletic please complete.
 
Clear selection
Athlete Agreement 
I declare that I am an amateur as defined by the UK Athletics rules and will abide by their rules. I hereby agree that Mote Runners shall not be liable for any injury, accident, loss or damage to myself or to anyone accompanying me due to my participation in any events entered by me or organised by Mote Runners. This will also apply to on or off-road training.

I agree to abide by the rules of Mote Runners and Mote Cricket/Rugby Club whilst on their premises. I declare that I am medically fit at the date of this application and that I will notify the Club at any stage if I am deemed not to be so by a registered doctor.

By ticking this box, I confirm that I have read and understood the privacy statement and how data will be used and shared and am willing to abide by the Club code of conduct (https://www.moterunners.co.uk/club-policies/) for athletes, coaches, team managers and volunteers – whichever applies to me as a member of the club.

Data Consent
I consent to my 'additional support' and medical data to be shared with coaches for the purposes of the delivery of my safe participation in Club activity. This data will not be shared or processed for any other purpose.

Collection and Storage of Personal Data
I agree to the Club collecting, storing and processing my data in line with the Data Protection Notice https://www.moterunners.co.uk/club-policies/. As a data subject you are not obliged to share your personal data with the Club. If you choose not to share your personal data with us we may not be able to register or administer your membership.
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Required
Additional Support
Please let us know if you have a disability and/or any additional support you may require from our club coaches.
Medical Conditions
Please tell us if you have any important medical conditions that our coaches should be aware of (e.g. epilepsy,
asthma, diabetes, heart conditions, allergies, etc.)
Emergency contact name *
Emergency Contact telephone number *
Publication of Photographs
The club maintains a public Facebook page https://www.facebook.com/moterunnersmaidstone/ and a public Instagram account https://www.instagram.com/mote.runners/ and a Website https://www.moterunners.co.uk/. Photos/videos of club members are periodically published on these pages to promote the club. However, members will not be tagged in these photos.
Please indicate if you do not wish to have any of your photos published to these public pages. If you join one of the Social Media pages/groups, please note that providers of the social media platform(s) have their own privacy policies and that the club do not accept any responsibility or liability for these policies.
Please check these policies before you submit any personal data on the club social media pages.
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Facebook / WhatsApp
The Club maintains a private Facebook group page and WhatsApp groups which all members are free to join and is used for club news and sharing activities amongst members. Please select any groups you wish to be added.
Signature *
Date *
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