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:
Details of Applicant
Details of the person applying for membership
Surname/ Second name
Date of Birth
Please use format: dd/mm/yyyy
Date of Birth
England Athletics (EA) number
If you already have an EA number, please complete this below:
Applicant Contact Details
Address including Post Code
e - mail address
Preferred contact phone number
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
£30 Under 17 FULL Membership (DOB between 01/09/2003 and 31/08/2009)
£15 Under 17 TRAINING ONLY
£30 Under 20 FULL Membership (DOB between 01/01/2001 & 31/08/2003)
£15 Under 20 TRAINING ONLY Membership
£25 Full-Time University Student FULL Membership
£10 Full-Time University Student TRAINING ONLY Membership
£35 Adult Senior FULL Membership
£20 Adult Senior TRAINING ONLY membership
£20 Over 65 FULL Membership
£5 Over 65 TRAINING ONLY Membership
£15 Under 11 Membership (DOB after 01/09/2009) This allows you to train and compete
£15 Second Claim Athlete
£10 Associate Member
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:
Second Claim Athletes Only - please confirm name of your First Claim Club
Emergency Contact Details
Emergency Contact Name
Emergency Contact Phone Number
Please include details of any medical information, e.g. allergies, medication, asthma
Medical Information (if none please state n/a)
Events: Please indicate your main areas of interest
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?
Assistant to Coach
Front Desk on Training Nights
Administration or ad-hoc 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)
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
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 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.
Online payment to a/c 60 22 91 48 Sort Code 20-20-15. Ref 'Memb' followed by applicant's name
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