Membership Form 2018-03-02T14:58:54+00:00

1st April 2018 to 31st March 2019

(Under 18s please complete U18 form.)

Personal Details

Emergency Contact Details

Medical Details

Please briefly list any medical conditions that the club should be aware of (e.g. epilepsy, diabetics,
allergies, etc.) You may be asked to provide further details by coaches or club officials. Please do not
leave blank – if there is no information please write ‘None’.

Membership Categories:

Full Member £33.00 (£18 Club Membership + £15 England Athletics registration fee)
This allows you to compete in races/events anywhere in the country for the reduced entry fee as a Poole
Runners member & be eligible to compete in our club championships.

Social/Associate Member £18 – For social and non-competitive runners. Does NOT include England
Athletics affiliation fee. Therefore any entries to races/events must be as unattached/no club & the
unattached entry fee paid. Not eligible for club championships.

Family Membership - 15% reduction off Poole Runners Membership for 3 or more family
members living at same address
(Therefore over 18 family membership = £18 less 15%, Total
£15.30 per person plus £15 EA membership, Total = £30.30 each)

‘100 Club’ Member £4 per month. Provides ‘Full Member’ entitlements including EA affiliation and
the chance to win up to £50 in the monthly ‘100 Club’ draw. To join simply arrange a £4 monthly direct
debit payment on 1st of every month, to Poole Runners bank account, details below.

Select Membership Type:
Full Member £33Social/Associate Member £18Family Membership100 Club

First Claim Club

- if not Poole Runners. This is relevant if you wish to belong to
two UK Athletics affiliated clubs. E.g. if you are currently living away from your
primary or home town club.


I wish to apply/renew membership of Poole Runners. I declare that the club or any of its coaches/officials
shall not be liable for any accident injury, loss or damage as a consequence of my membership of Poole

I am currently in good health and capable of taking part in running/athletics. Should any circumstances
change after joining or renewing I will update the club.

General Data Protection Regulation (GDPR)
When you become a full member of or renew your full membership with Poole Runners you will automatically be registered as a
member of England Athletics. We will provide England Athletics with your personal data which they will use to enable access to
an online portal for you (called MyAthletics). England 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). If you have any questions
about the continuing privacy of your personal data when it is shared with England Athletics, please contact:
Social/Associate member’s details will also be held by Poole Runners.

I agree to my personal details submitted on this form being held by the club for a period of up to two
years after receipt, for the purpose of club administration only.

Access to my details may be made available to coaches and authorised officers of Poole Runners solely
to facilitate club activities. Examples of this may include, but not limited to:
- Race/Event entry
- Club member demographic surveys
- England Athletics Registration

I acknowledge and agree with the club’s ethos of fair play and inclusion for all its members. I agree that a
good standard of behaviour is expected always, from all members and families, when attending events or
training supported by the club.

I agree that I will abide by the club’s constitution: View Constitution (opens in new window)

I agree that any photographs, including my image taken at club activities may be used for publicity and to
promote the club. I consent to the club recording and publishing my race results for the purposes of
publicity and club competitions.

-Free entry to The Junction Leisure Centre for club activities/events only is included in all membership categories.
Please show your valid Poole Runners membership card to reception staff on arrival.
-Pool/Gym/Classes use subject to The Junction’s charges/gym induction.
-Ashdown track fees not included in membership fee.

Payment Option

  • Via Bacs - Bank Account No: 21837125 Sort Code: 40-13-07 Account Name: Poole Runners
  • Via Online - Credit Card Using The Poole Running Events Website (Not available for Family and 100 Club memberships)
  • Via Cheque - Made Payable To Poole Runners
  • 100 Club - Please set up a standing order to pay £4 on the first of every month.

BACSOnlineCheque100 Club

If you have selected to pay online please go to