Young Athlete Registration Form 2011 - 2012

Stage 1. Your details

Stage 1 of 2

Your details Payment

Membership is open to all groups of the community.

Name
Date of birth

Address
Postcode

Tel (Home)
Tel (Mobile)

Sporting Information
To assist our coaches, please outline any previous participation in running/athletics. Details could include type (e.g. track or cross country), typical distances, and standards reached.

Annual membership / registration fees	Cost
Young Athlete Member (7-10 years old)	£15
Young Athlete Member Age (11-17 years old)	£20*

*This includes £5 affiliation to England Athletics, payment of which will give you 1st
claim status of the club and includes full competitive insurance.

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.)

Emergency Contact details

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

Contact name
Emergency contact number

To be completed by Parent/Guardian:

	I accept the below club terms and conditions By completed form, I agree to the child in my care (above) taking part in the activities of the club. 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. I consent to Wreake Runners occasionally photographing or videoing the child in my care (above) for promotional or training purposes.

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

Name of Parent/Guardian
Parents email address

Payment

How will you pay?

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

Code of Conduct
Wreake Runners is fully committed to safeguarding and promoting the well being of all its members. The club believes that it is important that members, coaches, administrators and parents associated with the club should, at all times, show respect and understanding for the safety and welfare of others. Therefore, members are encouraged to be open at all times and to share any concerns or complaints that they may have about any aspect of the club with the relevant club official.

As a member of Wreake Runners you are expected to abide by the following junior code of conduct:

All members must compete within the rules and respect officials and their decisions.
All members must respect the rights, dignity and worth of all participants regardless of gender, ability, cultural background or religion.
Members must wear suitable kit.
Members must pay any fees for membership or events promptly.

Child Protection
Wreake Runners recognises the need to ensure the welfare and safety of all young people in sport.

In accordance with our child protection policy we will not take photographs, video or other images of young people without the consent of parents/guardians. The club will ensure only the appropriate use of such images (primarily to record events and the achievements of our junior section) by following the guidance contained in the child protection policy (copy available from Club Secretary).

run@wreakerunners.co.uk

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

Wreake Runners based in Syston, Leicestershire

Registrations
New & Renewals

Kidz zone

Young Athlete Registration Form 2011 - 2012

Stage 1. Your details

run@wreakerunners.co.uk

Wreake Runners based in Syston, Leicestershire

Registrations New & Renewals

Kidz zone

Young Athlete Registration Form 2011 - 2012

Stage 1. Your details

run@wreakerunners.co.uk

Wreake Runners based in Syston, Leicestershire

Registrations
New & Renewals