Nuneaton Harriers - Annual Membership Form
1st April 2020 - 31st March 2021

You will receive an email giving you the information for payment of membership fee by bank transfer
Email address *
Full Name *
Title *
Address *
Date of Birth (dd/mm/yyyy) *
Age On Application *
Birthplace *
Home Phone Number *
Mobile Phone Number *
Do you wish to be 1st claim or second claim member *
Previous/Other Athletic Club
Nuneaton Triathlon Club Member *
Do You wish to be a competing or non-competing member *
What type of membership are you applying for *
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