Cheltenham & County Harriers Membership Application 2019/20
Application for Club Membership
Is this a Renewal or New Membership Application? NOTE: NEW Member Applications - please contact via email first to confirm there is a space available in the relevant training Group and to confirm fee payable as there is a discount after October 1 please email:
Details of Applicant
Details of the person applying for membership
Surname/ Second name
Date of Birth
Please use format: dd/mm/yyyy
Date of Birth
England Athletics (EA) number
If you already have an EA number, please complete this below:
Applicant Contact Details
Address including Post Code
e - mail address
Preferred contact phone number
For all Membership Types other than U11, Associate and Second-Claim, there are two levels of Membership and cost. If you wish to compete for the Club in track & field/ cross-country or road, you will need an EA number. FULL Membership includes a fee payable to England Athletics for this number. You may choose to be a Training Only Member, which does not therefore include the fee to England Athletics, and you will NOT be able to compete for the Club.
Membership Type Required: please read options carefully and select one
£30 Under 17 FULL Membership (DOB between 01/09/2002 and 31/08/2008)
£15 Under 17 TRAINING ONLY
£30 Under 20 FULL Membership (DOB between 01/09/1999 & 31/08/2002)
£15 Under 20 TRAINING ONLY Membership
£25 Full-Time University Student FULL Membership
£10 Full-Time University Student TRAINING ONLY Membership
£35 Adult Senior FULL Membership
£20 Adult Senior TRAINING ONLY membership
£20 Over 65 FULL Membership
£5 Over 65 TRAINING ONLY Membership
£15 Under 11 Membership (DOB after 01/09/2008) This allows you to train and compete
£15 Second Claim Athlete
£10 Associate Member
Second Claim Athletes Only - please confirm name of your First Claim Club
Emergency Contact Details
Emergency Contact Name
Emergency Contact Phone Number
Please include details of any medical information, e.g. allergies, medication, asthma
Medical Information (if none please state n/a)
Events: Please indicate your main areas of interest
The Club is run by a dedicated group of volunteers. Without volunteers, the Club could not exist. Please indicate any areas where you can offer support
In which areas can you offer support?
Assistant to Coach
Front Desk on Training Nights
Confirmation of Application
Please confirm that you are submitting this application for Membership and that you have read and accept the C&CH Membership Terms & Conditions. For applicants under 16 this confirmation must be by a parent / guardian
Name of applicant (or parent/ guardian)
Terms & Conditions / Data Protection Policy
To view a copy of the terms and conditions, please contact a member of the Executive committee.
Data protection policy. When you become a member of or renew your membership with Cheltenham and County Harriers you can also choose to be registered as a member of England Athletics (EA) -you will have to register with EA if you ever compete for the club. If you tick the box below we will provide EA 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).
If you have any questions about the continuing privacy of your personal data when it is shared with EA, please contact
If you do not tick the box below and then decide to compete for the club, we will need to register you with EA and we will inform you at the time.
I confirm that C&CH can share my personal data with England Athletics for the purposes stated above
Payment can be made in one of three ways.
Online payment is preferred if possible - details of Account listed below
Cheques can be posted to: C&CH Membership Secretary, 20b Winchester Way, Cheltenham, Glos. GL51 3HA; or handed to your Coach; or front desk on a training night;
Payment in Cash can also be handed in to your Coach or the front desk in a clearly marked envelope.
Indicate payment method
Online payment to a/c 60 22 91 48 Sort Code 20-20-15. Ref 'Memb' followed by applicant's name
Cheque payable to 'Cheltenham & County Harriers' with name of applicant on reverse and 'membership'
Cash - handed to desk on training session, or to your Club Coach; in envelope marked with applicant name and 'Membership'
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