here. - Leighton Fun Runners
Transcription
here. - Leighton Fun Runners
Membership Registration 2015 / 2016 Membership year begins 1st May to 30th April Full Annual Membership Cross Country Membership Last Quarter Membership 21 & Under Full membership LFR EA Membership £25.00 £15.00 £12.50 £15.00 £12.00 (Compete in XC races only. You do not have to pay if you have full membership.) (1st Feb – 30th April) England Athletics affiliation fees are £12. By having EA affiliation you consent to allow LFR to provide your details to EA officials. EA Affiliation allows entry to EA affiliated races without having to pay additional unattached levy. Please tick if you DO NOT consent to being attached to LFR. Your membership will be £25.00 (£15 if 21 or under) Bring along completed form & cheque on Tuesday club night or post to: Mariam Allen 45 Johnson Drive Leighton Buzzard LU7 4RT Cheques made payable to Leighton Fun Runners Alternatively transfer fees using your name as the reference to: HSBC Sort: 40-28-12 Account: 41097466 Name Address (with postcode) Telephone Emergency Contact Name/Number Email Address @ Date of Birth Data will be recorded for use within the club only. It will not be shared with any external agencies other than England Athletics. Disclaimer I hereby declare that Leighton Fun Runners will not be liable for any injury or loss/dame of personal property. Signed.............................................................................................................................. Date..............................................................