HARMENY ATHLETIC CLUB / Pentland Runners
MEMBERSHIP FORM

I*/We*, the undersigned, wish to apply for*/renew* membership of the Harmeny Athletic Club.  If granted membership of the club, I*/we* promise to abide by the Club’s Constitution & Rules at all times. Periodically, the club may pass membership details to Scottish Athletics.

Personal Details of Applicant(s) (BLOCK CAPITALS, please)
   
Surname   
Address   
   
Post Code    Tel Number  
Email Address   
 
First Name   Date of Birth  
School Attended
Signature of Applicant or Parent/Guardian if Applicant under 15    
IMPORTANT: Please state any medical condition and/or medication which should be drawn to the attention of the coaches   
Membership of any previous Athletic Club and date of resignation   
First Name    Date of Birth   
School Attended
Signature of Applicant or Parent/Guardian if Applicant under 15   
IMPORTANT: Please state any medical condition and/or medication which should be drawn to the attention of the coaches   
Membership of any previous Athletic Club and date of resignation   

(please enter any additional family members on the back)

(A) Harmeny Subscription: 1 Oct 2003 to 30 Sept 2004
     
£22 per person per year or  
£44 per family per year + £7 for 3rd & additional £________
family members £________

(1) On occasions, photographs may be taken of athletes competing, and these may be published in appropriate locations. Child Protection Regulations require parental/guardian permission for this, and by signing this form you hereby give this consent.
(2) Periodically, the club may pass membership details to ScottishAthletics.
(3) ScottishAthletics operates its own membership scheme, and all athletes competing in SA approved leagues, meetings and races etc require to have a valid SA membership number, issued directly by ScottishAthletics.

The completed membership form should be put in an envelope with the payment (cheques made payable to Harmeny Athletic Club) t to the Membership Secretary:

Paul McIntosh, 509A Lanark Rd West, Balerno, EH14 7AJ
Tel: 0131 449 5227 Email: paul.mcintosh@telinco.co.uk