APPLICATION FORM FOR MEMBERSHIP
ILFORD
ATHLETIC CLUB
|
WINTER
HEADQUARTERS 88A LAMBOURNE ROAD, CHIGWELL ROW |
Founded 1923 |
SUMMER
HEADQUARTERS: CRICKLEFIELD ATHLETIC GROUND, ILFORD |
|
|
FOR OFFICIAL USE ONLY |
|
|
|
MEMBERSHIP NO. |
|
|
AFFILIATED
TO UK ATHLETICS |
DATE OF ELECTION |
|
|
CATERING FOR
ALL BRANCHES OF ATHLETICS AND ALL AGES |
FEE PAID |
|
|
Mr/Mrs/Ms/Miss/Other: |
First names: |
Surname: |
|
|
Full postal address: |
|||
|
|
Post Code: |
||
|
Telephone
Nos. Home: Email address: |
|||
|
Date of
birth: Age: |
|||
|
Place of
birth: COUNTRY COUNTY
(if born in United Kingdom) |
|||
|
If born
overseas please give date of arrival in the United Kingdom: and current
nationality |
|||
|
We are
obliged to register you with the South of England Athletic Association if you
are over 16 and you are not a British Subject. If you have competed at national level you may be required to
produce a letter of clearance from your Country’s Athletic Association. |
|||
|
If you have competed in a County Championships please
state which County and when: |
|||
OTHER
ATHLETIC CLUBS
|
|||
|
If you are joining as a second claim member please give
the name of your first claim Club: |
|||
|
If you have
previously been a member of another athletic Club and resignation was in the
last nine months a letter of clearance giving date of resignation must
be attached to this application form.
If resignation was more than nine months ago then give date of
resignation and name and address of Club secretary |
|||
|
Date of
Resignation: Previous
Club’s name: |
|||
|
Name and address of previous Club’s Secretary: |
|||
PLEASE
TICK AREAS OF SPECIAL INTEREST
|
|||
|
Sprints |
|
Hurdles |
|
Middle
Distance |
|
Long
Distance |
|
Walking |
|
|
Throws |
|
Jumps |
|
Road Running |
|
Cross
Country |
|
Jogging |
|
|
Officiating |
|
Coaching |
|
Social |
|
Supporter |
|
|
|
|
|
I HEREBY
DECLARE: |
|
1. |
That I am Amateur according to the UK Athletics
Rule 1, eligibility to compete. |
|
2. |
That I will abide by the UK Athletics Laws and Regulations
for Competitors. |
|
3. |
That I have not competed at an Unregistered Meeting, or if
having so competed I have since been re-qualified. |
|
4. |
That Rule 3 of UK athletics Constitution and Rules for
Competition relating to Club Membership including the First Claims Rule has
been fully explained to me and I understand the terms of my Club Membership. |
|
5. |
That I will show courtesy to all officials, coaches and
other athletes and remember that the referee’s decision is final. |
|
6. |
That I will wear a Club vest when competing for the Club. |
|
7. |
That I will purchase a ticket (from the Swimming Pool
Office) for use of the track. |
|
8. |
That I will observe Club rules. |
|
9. |
That the above particulars are complete and correct. |
|
10. |
Any IMPORTANT
MEDICAL FACTS have been noted on an attached sheet |
|
SIGNATURE OF
APPLICANT: ____________________________ |
DATE:
_________________________________ |
|
PARENT’S CONSENT SIGNATURE (Required for applicants aged 16 and
under) |
_______________________________________ |
|
Proposed by: __________________________________________ |
Seconded by: ____________________________ |
|
(Both
members of the above-mentioned Club – must be signed) |
|
Application
together with subscription to be sent to:
Alan Lovett, IAC Membership Secretary, 12 Dunspring Lane, Clayhall, Ilford, Essex IG5 0TZ
Subscription
rates (payable with application and thereafter in advance on 1st September
each year);
Seniors £35;
Juniors £14; Students £14; Honorary £7; Second Claim £18
Other membership
fees as appropriate: Husband & Wife; Partners; Additional Family Members