Application form for Senior members
Longford Athletic Club
First Name *
Your answer
Surname *
Your answer
Sex *
Address *
Your answer
Contact Mobile number *
Your answer
Contact Email Address *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Any Medical Conditions *
Were you a Longford AC Member in the last 4 Years *
Previous Club Membership(if Any, incl. End Date)
Your answer
Do you authorise addition to Longford AC Communication mediums. ie whats-app, text messages? *
Club Policies: I understand that membership is conditional on compliance with Longford Athletic Club policies. (see our website, Longfordac.com for club policy documents) *
Required
Photographs: I understand that photographs will be taken during, or at, sport related events and may be used in the promotion of the sport. *
Required
Drug Testing (for elite athletes only): I give permission to be tested for prohibited substances in accordance with the Irish Sports Council Anti- Doping Rules (where applicable). *
Required
GDPR Consent: I give consent that my data\information may be used and retained in accordance with Longford AC’s PrivacyPolicy and Statement *
Required
Code Of Ethics: I hereby give consent participating in activities of the organization in line with the Code of Ethics. *
Required
Health & Possessions: I Agree that Longford Athletic Club is not responsible for my Health or Possessions during any activitiesAnd that I participate at my own risk. *
Required
I confirm that all details are correct, and accept membership is only completed on payment of annual membership of €30.00 (includes AAI registration) *
Required
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