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Please
print this form off and send, with correct fee, to The Secretary.
First
Name
Surname
............................
Date
of Birth
.Place of
Birth.................................................
Address
........
........Post
Code..........................................................
Telephone No
..........email
address...................................................
I
apply to become a member of St Helens-Sutton Athletic Club and agree to
abide by the Constitution of the Club and the rules of UK Athletics.
Signed
.........
......... Date...................................
Parent/Guardian Signature (if under
18).........................................................................
If you
are, or have been, a member of another club please give the name of the club,
dates of membership, including date of resignation........................
Events
in which you are interested
..................
Please
Note: Date Protection Act. Information provided on this form will be held on
computer disks and only used in the administration of the club. Your rights
of access to any such
information are guaranteed by the Date Protection Act.
FOR OFFICIAL USE ONLY
Subscription Paid £
.................... Date of Election
.........
Minimum Age 8. No Maximum.
Seniors £15 --- Juniors/Students (11-19) £10 --- Under 11 £5 ---
Family Membership on application. |
