Peterhead Athletics Club
Membership Form
2015 / 2016
www.peterheadathleticsclub.co.uk
Email:secretary@peterheadathleticsclub.co.uk
SURNAME:
FIRST NAME:
ADDRESS:
POSTCODE:
D.O.B:
GENDER:
TEL:
MOBILE:
EMAIL:
SAL NO:
Type of application (First time, renewal)
please specify
Other club membership held, please give
details
Data Protection: Your details will be held on our database and will only be passed to scottish
athletics for information. If you do not wish your information to be stored please tick here ( ).
Membership Types
Senior (age 20 or over)
£20.00
Junior
£12.00
Associate
£FREE
Family (please complete a separate form for each
£50.00
family member)
I enclose cash/cheque for £
(cheques made payable to Peterhead Athletics Club)
Signature:
Date:
____________________________________________________________________
For completion by parents of juniors
Does your child suffer from asthma, epilepsy, heart trouble or any other medical condition
we should know about?
Yes/No (please delete)
If yes, please specify
Photographs: We regularly have a club photographer at events to take pictures for our
website or for the local newspaper, do you permit the club to display pictures of your child:
Yes/No (please delete)
Emergency Contact - please supply details of someone we can contact in an emergency:
Name:
Relationship:
Tel No:
Mobile No:
Signature:
Date:
Please send completed applications to: Membership Secretary, Teresa Hood, 24 Morrison
Place, Cruden Bay, Peterhead, Aberdeenshire, AB42 3HW
email:secretary@peterheadathleticsclub.co.uk