Matlock AC Membership Form
Welcome to Matlock Athletic Club. We are an ARC* and UKA* Affiliated Athletic Club, open to athletes of any ability from seven years of age. Please fill out all sections and sign in the appropriate place.

Club Membership Costs Senior £14 - (if UKA Affiliation required add £15) : Junior - £10 – (UKA Affiliation subsidised by the Club only upon application and agreement to and by the Committee).

First Name *
Your answer
Surname *
Your answer
Address *
Your answer
Post Code *
Your answer
Date of Birth (click on the drop down for calendar) *
MM
/
DD
/
YYYY
County Of Birth *
Your answer
Mobile Number *
Your answer
Email Address *
Your answer
Telephone Number *
Your answer
Is this a First or Second Claim Membership *
If First claim is UKA required (Seniors only)
If First Claim is this subject to First Claim Transfer
Are you Under 16 on 1st April 2018 *
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