Cheltenham & County Harriers Membership Application 2020/2021
Application for Club Membership
Is this a Renewal or New Membership Application? NOTE: NEW Member Applications - please contact via email first to confirm there is a space available in the relevant training Group. Please email: membership@cheltenhamharriers.co.uk *
Details of Applicant
Details of the person applying for membership
First Name *
Your answer
Surname/ Second name *
Your answer
Gender *
Date of Birth
Please use format: dd/mm/yyyy
Date of Birth *
Your answer
England Athletics (EA) number
If you already have an EA number, please complete this below:
EA Number
Your answer
Applicant Contact Details
Address including Post Code *
Your answer
e - mail address *
Your answer
Preferred contact phone number *
Your answer
Membership Type
For all Membership Types other than U11, Associate and Second-Claim, there are two levels of Membership and cost. These are FULL and Training Only. If you wish to compete for the Club in track & field/ cross-country or road, you will need an EA number. FULL Membership includes a fee payable to England Athletics for this number. You may choose to be a Training Only Member, which does not therefore include the fee to England Athletics, and you will NOT be able to compete for the Club.
Membership Type Required: please read options carefully and select one *
Family Membership Option. The Club offer a Family option, to pay £30 for Family membership, plus an additional £15 for each Family Member that requires an EA number in order to compete. If this application is linked to other Family Members in order to use this discount, please list the related names below. Each name will need to submit a separate application, with a Membership Type selected as above. It is only the overall cost that is different. Related names:
Your answer
Second Claim Athletes Only - please confirm name of your First Claim Club
Your answer
Emergency Contact Details
Emergency Contact Name *
Your answer
Emergency Contact Phone Number *
Your answer
Medical Information
Please include details of any medical information, e.g. allergies, medication, asthma
Medical Information (if none please state n/a) *
Your answer
Event Preferences
Events: Please indicate your main areas of interest *
Required
Volunteering
The Club is run by a dedicated group of volunteers. Without volunteers, the Club could not exist. Please consider how you might be able to offer even just a few hours over the course of the season. Indicate below the areas where you could offer support
In which areas can you offer support?
Confirmation of Application
Please confirm that you are submitting this application for Membership and that you have read and accept the C&CH Membership Terms & Conditions. For applicants under 16 this confirmation must be by a parent / guardian
Name of applicant (or parent/ guardian) *
Your answer
Terms & Conditions / Data Protection Policy
To view a copy of the terms and conditions, please contact a member of the Executive committee.

Data protection policy. When you become a member of or renew your membership with Cheltenham and County Harriers you can also choose to be registered as a member of England Athletics (EA) -you will have to register with EA if you ever compete for the club. If you tick the box below we will provide EA with your personal data which they will use to enable access to an online portal for you (called myATHLETICS). England Athletics will contact you to invite you to sign into and update your myATHLETICS portal (which, amongst other things, allows you to set and amend your privacy settings).
If you have any questions about the continuing privacy of your personal data when it is shared with EA, please contact dataprotection@englandathletics.org.
If you do not tick the box below and then decide to compete for the club, we will need to register you with EA and we will inform you at the time.
I confirm that C&CH can share my personal data with England Athletics for the purposes stated above *
Payment Information
Payment to be made by bank transfer, account details below. When making the payment, please use the Reference 'Memb' followed by applicant's name. This enables us to reconcile payments.
Payment confirmation *
Required
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