Changed Your Details?

Please let us know if you have changed your contact details, ICE, or need to let us know about any health issues that may have developed.

Name *

First

Last

Email *

Date of Birth *

Please enter your date of birth in the format dd/mm/yyyy

Gender *

Female
Male

Address 1 *

Address 2

Town/City *

Poatcode *

Mobile or Phone Number *

Emergency Contact 1 *

Please insert the information to indicate the persons who should be contacted in event of an incident/accident.

Emergency Contact Number *

Emergency Contact 2

Please insert the information to indicate the persons who should be contacted in event of an incident/accident.

Emergency Contact Number 2

Additional Support

Please detail aboveany disability you have and/or any additional support you may require from our club coaches

Any Known Medical Conditions *

Please detail above any important medical information that our coaches/junior coordinator should be aware of (e.g. epilepsy, asthma, diabetes, allergies, etc.) Please do not leave blank – if there is no information please write ‘None’

Do you wish to continue to receive the Quakers newsletter and other email communications?

Yes please
No thank you

Signature *

Please add your name here to indicate you have completed all required fields AND that you agree to the terms of our privacy policy.

Date *

Name

By completing your registration, you agree to the following statements:

You understand that your full club membership will only be confirmed when your membership payment is received.
You understand that there will not be any charge for any initial training sessions with the club, but that after a period of a month, unless otherwise agreed, it is expected that you will then pay for full membership with Quakers Running Club should you wish to continue to take part in the organised activities – with the exception of our Beginner’s Group, where the course fee covers the entire duration of the course.
You understand that you are taking part in any organised activity with Quakers Running Club at your own risk, that you are only covered by the clubs England Athletics Coaches Insurance for a trial period, and will not be then fully covered until such time that you pay for full membership with Quakers Running Club, or another affiliated running club. (Full details of the insurance can be found at www.englandathletics.org)
You understand that your personal information will be managed in accordance with the Quakers Running Club Terms of Service, Privacy Policy and Communication Policy and you agree to abide by Quakers Running Club policies.

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Changed Your Details?

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