Crystal Palace Fun Runners
Membership Form 1st April 2019 - 31st March 2020
ATHLETE DETAILS
First Name *
Your answer
Surname *
Your answer
Gender *
Date of birth *
MM
/
DD
/
YYYY
CONTACT DETAILS
Address Line 1 *
Your answer
Address Line 2
Your answer
Town/City *
Your answer
County
Your answer
Postcode *
Your answer
Home telephone number *
Your answer
Mobile Number *
Your answer
Email Address *
Your answer
Emergency Details
Emergency Contact Name & Number *
Your answer
Do you have an existing medical condition which might result in you requiring urgent medical attention? *
If yes please provide details below (or type 'none' for no). This information will remain strictly confidential and will only be accessible to the relevant senior club members
Your answer
Are you medically trained?
If yes please provide details ie. doctor, nurse, paramedic, first aider
Your answer
General
Group you usually run in or if a new member pace you normally run at *
This helps us with admin
How did you hear about us? *
This helps us with admin
MEMBERSHIP
Membership runs from 1st April 2019 - 31st March 2020.

By paying you are agreeing to abide by the clubs rules and club safety rules. These can be found on our home page.

MEMBERSHIP TYPE *
Please select the type of membership you would like from the following options:
ENGLAND ATHLETICS AFFILIATION NUMBER
(if known)
Your answer
Do you belong to another club?
Your answer
PAYMENT DETAILS
Payment is now processed via England Athletics (EA). You will receive a separate email from England Athletics (noreply@englandathletics.org) with a link to an online payment facility. Please select the amount you have agreed the pay below and select submit. You should then receive an email from EA requesting payment within 7 days.
AMOUNT PAID *
Club privacy statement
Crystal Palace Fun Runners (The Club) take the protection of the data that we hold about you as a member seriously and will do everything possible to ensure that data is collected, stored, processed, maintained, cleansed and retained in accordance with current and future UK data protection legislation.

Please read the full privacy notice carefully to see how The Club will treat the personal information that you provide to us. We will take reasonable care to keep your information secure and to prevent any unauthorised access.

Personal Information Disclaimer *
I consent to Crystal Palace Fun Runners holding personal information about me for the purpose of the administration of my membership with the club (no marketing). In doing so I consent to be being contact by the club by email, phone and text (SMS) message.
Required
Data Sharing with England Athletics
When you become a member of or renew your membership with Crystal Palace Fun Runners you will automatically be registered as a member of England Athletics. We will provide England Athletics 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). It is vital, therefore, that a valid email address is given, so that you can ensure that your data is correct and so that you can set your own privacy settings.

If you have any questions about the continuing privacy of your personal data when it is shared with England Athletics, please contact dataprotection@englandathletics.org.

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