Join us!

If you would prefer to fill out a membership form manually yourself, you can download it here

A. Personal Details

Title *

Forename *

Surname *

Date of Birth *

Sex at birth *

Street Address *

Town *

Post code *

Home phone

Mobile phone

Email Address *

Confirm Email Address *

B. Application Type *Please indicate the type of membership you are applying for

C. Club HistoryComplete details if you have been or are a member of another atheltic club

Club Name

EA Registration Number

D. Medical Details *Please state if there are any medical details that group leaders needs to be aware of. If there is no information, please write ‘None’. The club requires that all members carry “In Case of Emergency” (ICE) details on them whilst running with the club.

E. Additional SupportPlease detail any disability you have and/or any additional support you may require from our club leaders.

F. Emergency Contact Details

Name

Phone Number

Relationship to applicant

Declaration

I wish to join Desborough and Rothwell Running Club and agree to the following:

The above details are correct; my name, medical details and emergency contacts will be entered into the Desborough & Rothwell Running Club membership database.
That my details can, where applicable, be passed to England Athletics for the purpose of national affiliation (for more info see data protection statement).
To sign up to the relevant England Athletics Codes of Conduct
To be bound by the UKA Anti-Doping Rules and has agreed to sign up to the Senior Athletes Code of Conduct.
That I have read and accept the data protection statement.
To accept and abide by the club rules and constitution and by the rules of UK Athletics.
That participation in running is entirely at my own risk.
To inform the membership secretary of any change in my details.

Terms Consent *I accept terms set out in the club declaration above.

Data Consent *I consent to my special category personal data provided in section D and E to be shared with leaders for the purposes of the delivery of my safe participation in club activity. This data will not be shared or processed for any other purpose.