Please also visit us on..
CAERPHILLY RUNNERS
Home
About
Coaches
Club Constitution
Committee
Safeguarding
Training
Tuesday Club Session
Social Running
Wednesday Sofa to 5k
Wednesday Evening Session
Trail Thursday
Sunday Morning Club Run
Club Competitions
Caerphilly Runners Handicap Challenge
Club Championship
Past Champions
Contact
Membership
Our Members
Photos
Meet our Runners
Club Membership
Please fill out you details in the form below |
*
=
Mandatory fields
Please ensure that you make a payment immediately after completing this form, you will not be a confirmed member until we have received payment from you.
New & Renewing members
Under 20: £30
Standard: £40
Second claim: £19
Please use the following details for paying via bank transfer:
Sort Code: 09-01-28 &
Account No.: 75229253
Please include your
Surname
,
Initial
and
NM
(new members),
CM
(current members) or
U21
(for U21) clearly in the
Referen
ce field.
*
Indicates required field
Please select membership type
*
Please select from list
Senior Membership (over 20 years)
Junior Membership (17-19 years)
Second claim membership
If this is a Second Claim membership, please supply your Welsh Athletics number
*
Your Details
New Member's Name
*
First
Last
Please enter your name
Date of Birth
*
Enter full date: DD / MM / YYYY
Telephone number (Main)
*
Please enter a home or mobile number
Telephone Number (other)
*
Please enter a home or mobile number
Home Address
Address - Line 1
*
Address - Line 2
*
Town / City
*
Post Code
*
Email
*
How did you here about us?
*
Choose an option
Facebook
Twitter
Search Engine
Friend, Family or Colleague
Through a club member
Local Press
Saw runners at an event
Other
Emergency Contact Name
*
Emergency Contact Number
*
Medical Information
Please detail below any important medical information answer, such as heart conditions, epilepsy, asthma etc . If you have any questions please ask for advice from the one of the Welfare Officers
*
Has a Doctor ever advised you not to exercise ?
*
Yes
No
Have you got a medical condition that may get worse when running ?
*
Are you currently pregnant ?
*
Not Applicable
Yes
No
Prefer not say
I confirm that the details provided are correct and it is my responsibility to notify Caerphilly Runners (CR) of any changes. I also agree to CR using my personal details for internal Club communication and announcements. CR will not pass these details on to any third party. I also confirm that I fully accept and understand that any activity I participate in, arranged by CR, I do so entirely at my own risk and also understand and agree that CR cannot police or monitor the taking of photographs at open events and public venues and is therefore my responsibility to approach the publisher of any media to request its disuse and removal. When you become a member of or renew your membership with Caerphilly Runners you will also be registered as a member of Welsh Athletics. By ticking the box below we will provide Welsh Athletics with your personal data which they will use to enable access to an online portal for you (called myATHLETICS). Welsh 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)
*
I confirm
Signed
*
Please enter your name
Today's date
*
Enter full date: DD / MM / YYYY
Please tick the box below to confirm that you are aware of our club safeguarding policies and procedure. https://www.caerphillyrunners.wales/safeguarding.html
*
I confirm
An comments or questions?
*
A chance to add further comments or ask questions regarding your membership application
Submit