- Hatch Warren Runners

HATCH WARREN RUNNERS (HWR)
MEMBERSHIP FORM 2015
Club Subscription: £25.00 (includes England Athletics Registration Fee)
Membership runs from April 01 to March 31 each year - Second claim members: £12.50
PLEASE COMPLETE AND RETURN WITH PAYMENT TO THE CLUB TREASURER
(M Butler, 35 Highdowns, Hatch Warren, Basingstoke, Hants RG22 4RH)
Please make cheques payable to Hatch Warren Runners
Electronic Payments can be sent to Sort Code 30-90-53, Account Number 43031268
Please quote your name as the reference
You may type in the details first, save it on your computer if desired then print it; don’t forget to sign at the bottom though!
You may scan a signed copy of the membership form through to [email protected]
First Name(s)
Last Name
Date of Birth
Address
Postcode
Telephone Number (including STD code)
Mobile Number
E-mail address
Second claim members, who is your 1st claim
club?
Club Shop - please enter your club shop order below if required.
eg. 1 x male vest size 40, 1 x T-Shirt size 40
We hold a limited stock at the club shop. If your garment is out of stock it will be added to our next club order. Orders are submitted
as and when we have a large enough volume to do so.
I certify that the information given above is correct. I have read the 2015 rules and constitution of HWR and
agree to abide by them. I declare that I am an amateur as defined by the UK Athletics rules and that I will
abide by these rules. I am medically fit and understand that I participate/enter in any club activities/events
entirely at my own risk. I agree that Hatch Warren Runners shall not be liable for any accidents, injury, loss,
damage or claim or expense that may arise in consequence of my participation in club activities/events
SIGNED
_____________________________________
DATE
_____________________________________
HWR state that data will be maintained in accordance with the Data Protection Act and will only be used for internal
purposes. It will not be disclosed to third parties.