Application Form - new members only

this is an application form for a normal membership. It does not include the cost of the beginners course. When we have the details confirmed a new form will be posted


You can mail us to ask for a PDF or word format application form, but if you want to get started straight away you can copy the form below into a word processor and send your application off right away.

Please note we can currently only accept cash or cheques with applications.

Southampton Running Sisters Application Form

Name:

Address:

Post Code:

Telephone (daytime):

Telephone (evenings):

Email (please write clearly):

Emergency Contact – Name:

Emergency Contact – Telephone:

Please tick appropriate boxes below:

What is your running experience?

Complete beginner □ Some experience □

Have you ever belonged to another running club?
□
Are you currently a member of another running club?
□
If so please name it here


Medical information:

Please write down ANY medical condition Southampton Running Sisters should be aware of e.g.
back/knee injuries, high blood pressure, diabetes, asthma




Your date of birth
Note: Southampton Running Sisters is a club for those over 18 years of age only - we also need this information for age classification in any competitions you participate in

I wish to join Southampton Running Sisters


SIGNED……………………………………… Date……………

Please return the completed form by
post with payment enclosed to:


Tina Dempster, Membership Secretary
15 York Close,
Horton Heath,
Eastleigh
SO50 7PX

annual membership £15
□
annual membership(concessions) £10
□
Fee includes affiliation to UK Athletics.

Note: Membership is due for renewal on
1st January each year

*cheques (payable to Southampton Running Sisters) or Postal Order only – no cash by mail

Please enclose a stamped self addressed envelope for acknowledgment if you have no email.