Registrations
New & Renewals

Pay online now!

Kidz zone

Info 4 the young members

Join the chat

The Wreake
Runners Forum

Race Results

View full results list

Adult Registration Form 2009-10

1. Your details

Stage 1 of 2

Your details Payment

Membership is open to all groups of the community

Member 1
Name
Date of birth
Date you joined the club
Email

Member 2*
Name
Date of birth
Date you joined the club
Email

Member 3*
Name
Date of birth
Date you joined the club
Email

Member 4*
Name
Date of birth
Date you joined the club
Email

*Additional Adult membership

Address
Postcode

Tel (Home)
Tel (Mobile)

Annual membership / registration fees	Cost
Each Adult Runner + optional affiliation to England Athletics	£16* £5
Each additional Adult Runner (sharing newsletter) + optional affiliation to England Athletics	£14* £5
Each Associate (Non Runner) Member	£10

*£1.00 of this is for Mandatory Affiliation Fees to the Association of Running Clubs (ARC).

Your personal bests
Please take the time to complete if applicable. These will be used for PB listings

					Best in your present veteran age group**
Name	10k	10Miles	1/2 Mara	Full Mara	10K	10Miles	1/2 Mara	Full Mara

** Vet Groups 40-49, 50-59, 60-69 and over 70

Medical information

Please detail below any important medical information or disabilities that our coaches/ coordinators should be aware of (e.g. epilepsy, asthma, diabetes etc.)

Name	Condition / Details

Emergency Contact details

Please indicate person(s) who should be contacted in case of an accident/incident:

Contact name
Emergency contact number

	I accept the below club terms and conditions Please accept my/our application for Wreake Runners membership. I/we agree to abide by the rules of the Club and agree that neither the Club nor any of its officers shall be responsible for any claim relating to accident, injury, damage, or loss sustained by me/us during any Club activity.

	Please tick box if you DO NOT wish photographs or information to be used on the internet or other media.

Payment

How will you pay?

I will pay online now via PayPal
I will send a cheque

run@wreakerunners.co.uk

Adults:
Tuesday 6:45pm
Thursday 6:45pm
Juniors:
Saturday 10:30am

Wreake Runners based in
Syston, Leicestershire

Registrations New & Renewals