<p> HOLMFIRTH HARRIERS ATHLETIC CLUB Member of England Athletics & British Triathlon Association</p><p>MEMBERSHIP APPLICATION FORM (to be completed in BLOCK LETTERS)</p><p>Address:</p><p>Postcode:</p><p>Telephone:</p><p>E_mail address:</p><p>Title First name Surname Sex Age Date of birth County & country of birth</p><p>Please give details of clubs you have been or are a member of:</p><p>I/We hereby apply to become a Member of Holmfirth Harriers Athletic Club and agree to abide by the Rules and Constitution of the Club. I am, as far as I am aware, fit to take part in any physical activity. A copy of the Rules and Constitution are available from the Secretary, please see website for details.</p><p>Data provided will be protected by the Data Protection Act, for Administration purposes only, under the auspices of England Athletics Photographs of you while competing may be used for promotional purposes, if you object please indicate by ticking the box [__] </p><p>PLEASE NOTE Renewals are due on 1st April, even if you join part way through the year, except for new members who join in January, February or March. The fees below include a one-off £10 joining fee (this is not charged for renewals on 1st April unless the membership has lapsed) and an annual fee to England Athletics of £14pp for a race license.</p><p>Signed: Date:</p><p>Fees Quantity Total £</p><p>Aged 8 to 9 £35</p><p>Aged 10 to 17 £45 (and those over 17 in full time education) Seniors £60</p><p>Families: £90 plus Family membership + £14 fee per person aged 10 or above (including adults). £14 per person aged 10 or above. Associa Associates: (non running members) £20</p><p>TOTAL FEE</p><p>Completed forms with correct money to be forwarded to: HHAC Membership, 8B Oldfield Road, Honley, Holmfirth, HD9 6RL (Cheques made payable to HHAC)</p><p> www.holmfirthharrier.com HOLMFIRTH HARRIERS ATHLETIC CLUB Member of England Athletics & British Triathlon Association</p><p>ACTIVITY REGISTRATION FORM (for ADULTS & Juniors)</p><p>Activity Venue Start Time 7pm Holmfirth Harriers Training Neiley Pavilion, Honley. Finish Time 8.15pm for juniors, up to 9pm for Sessions. seniors</p><p>PARTICIPANT DETAILS: Surname: Telephone:</p><p>Address:</p><p>Postcode:</p><p>Name: DOB: Age: Gender: School(if applicable): Person 1 M / F Person 2 M / F Person 3 M / F Person 4 M / F Person 5 M / F Person 6 M / F Person 7 M / F</p><p>EMERGENCY CONTACT DETAILS: Name of Parent/Guardian/Contact Emergency Contact Number during training times. Medical conditions the coach should be aware of:</p><p>Please use back of form if more space required,</p><p>JUNIOR DETAILS: YOU ARE RESPONSIBLE FOR DELIVERING YOUR CHILD TO THE CLUBHOUSE PRIOR TO THE SESSION. JUNIOR MEMBERS MUST NOT BE ALLOWED TO STAY ON THE FIELD FOR HEALTH AND SAFETY REASONS AND MUST REPORT TO THE CLUBHOUSE. YOU ARE RESPONSIBLE FOR YOUR CHILD UNTIL THEY DO SO BETWEEN 6.45PM AND 7.00PM. THE JUNIOR SESSION FINISHES AT 8.15pm AT THAT TIME YOU ARE RESPONSIBLE FOR YOUR CHILD’S WELFARE</p><p>Signature of RUNNER (or parent/guardian for juniors): ……………….………………………………</p><p>PLEASE ENSURE THE PARTICIPANT IS WEARING SUITABLE CLOTHING, AND THAT THEY HAVE ADEQUATE/APPROPRIATE REFRESHMENTS FOR THE DURATION/NATURE OF THE ACTIVITY. IF YOU USE AN INHALER YOU NEED TO REGISTER. PLEASE ASK A SENIOR COACH FOR A FORM AT ONCE, DON`T WAIT TO BE CAUGHT OUT FOR THEY MAY CONTAIN A BANNED SUBSTANCE.</p><p>Completed forms with correct money to be forwarded to: HHAC Membership, 8B Oldfield Road, Honley, Holmfirth, HD9 6RL (Cheques made payable to HHAC)</p><p> www.holmfirthharrier.com</p>