Membership Form Page

SECTION A: ATHLETE DETAILS

1. First Name *
2. Surname *
3. Address *
4. Postcode *
5. Telephone *
6. Date of Birth (DD/MM/YYYY) *
7. Email *



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SECTION B: ADDITIONAL SUPPORT

Please detail below any disability you have and/or any additional support you may require from our club coaches

8. Additional Support *



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SECTION C: MEDICAL INFORMATION

Please detail below any important medical information that our coaches should be aware of (e.g. epilepsy, asthma, diabetes, allergies, etc.) Please do not leave blank – if there is no information please write ‘None’

9. Medical Information *


10. I consent to my special category personal data provided in section B and C to be shared with coaches/run 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



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SECTION D: EMERGENCY CONTACT DETAILS

Please insert the information below to indicate the persons who should be contacted in event of an incident/accident

11. Emergency Contact one name *
12. Emergency Contact one number *
13. Emergency Contact two name *
14. Emergency Contact two number *



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SECTION F: CLUB PRIVACY STATEMENT & COMMUNICATION PREFERENCES

Hungerford Hares takes the protection of the data that we hold about you as a member seriously and will do everything possible to ensure that data is collected, stored, processed, maintained, cleansed and retained in accordance with current and future UK data protection legislation. Please read the full privacy notice carefully to see how The Club will treat the personal information that you provide to us. We will take reasonable care to keep your information secure and to prevent any unauthorised access



15. I agree with your terms and conditions Privacy Policy



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SECTION G: DATA TRANSFER TO ENGLAND ATHLETICS

When you become a member of or renew your membership with Hungerford Hares we will register you as a member of England Athletics (you will need to be registered with England Athletics if you ever compete for the club in competition Under UKA Rules). We use a system provided by England Athletics to manage memberships and request payments, amongst other club administration tasks. By ticking the box below you are giving Hungerford Hares permission to share your information with England Athletics. England Athletics will contact you to invite you to sign into and update your MyAthletics portal (which, amongst other things, allows you to set and amend your privacy settings). If you have any questions about the continuing privacy of your personal data when it is shared with England Athletics, please contact dataprotection@englandathletics.org.



16. I am happy for Hungerford Hares to share my personal information with England Athletics



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SECTION H: ATHLETE AGREEMENT

By returning this completed form, I confirm that I have read and understood the privacy statement and how data will be used and shared and am willing to abide by the club code of conduct for athletes.



17. I have read the Senior Athlete Code Of Conduct



By signing your name electronically on this membership form, you are agreeing that your electronic signature is the legal equivalent of your manual signature on this membership form.

18. Signature *
19. Print Name *
20. Date *

* Required