Application form for Juvenile members
Longford Athletic Club
First Name of Athlete *
Your answer
Surname of Athlete *
Your answer
Sex of of Athlete *
Little (indoor) or Juvenile (outdoor) Athletics *
Address of Athlete *
Your answer
Mobile contact number Of Parent/Guardian if child under 18 Years of Age *
Your answer
Email Address Of Parent\Guardian if child under 18 *
Your answer
Date of Birth of Athlete *
MM
/
DD
/
YYYY
Any Medical Conditions of Athlete *
PARENTAL/GUARDIAN CONSENT I confirm i am the Parent/Guardian my name is: *
Your answer
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 I am able to give parental consent for my child(ren) to participate in and travel to all activities *
Required
I Understand that membership is conditional of payment of club membership. *
Required
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