Derbyshire Dynamos Membership Form
1st April 2021 to 31st March 2024/25
Email *
Title *
First and last name *
Address *
Postcode *
Email *
Phone number *
Date of Birth *
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URN if known *
Do you consider yourself to have a disability or any additional needs?
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Gender *
Details
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I agree that Derbyshire Dynamos may share my data with England Athletics. This is an England Athletics requirement for all affiliated running clubs for their administrative purposes.
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DATA PROTECTION From 25th May 2018 the new EU General Data Protection Regulation (GDPR) will come into affect. To comply with this regulation Derbyshire Dynamos requires an applicants consent to hold, share and use the data provided for the activities arising from Club membership.
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I give permission for any images taken of me by the Derbyshire Dynamos' appointed photographers to be used for the purpose of publishing and promoting the club.
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I agree that Derbyshire Dynamos may hold my data and use it to contact me regarding club activities.
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Payment:                                                                                    Bank Transfer: £25.00                                                                                          
£27.50 (PayPal incurs additional fees (a recurring annual payment will be set up until cancelled by member))
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Peak Running / Jog Derbyshire Promo Code
A copy of your responses will be emailed to the address you provided.
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