Registration Form

Personal Details = required

Full Name

Home Address

Home Phone

Work/Other Phone

Mobile Phone

Email Address

Alternate Email

Date of Birth

Gender

Male Female

Occupation

(Please indicate if you would be willing to help the club should it need your expertise.)

Coaching Start Option

Please select the Coaching Start Option that you would like to join?

Endurance Long, Triple, High Saturday Yr 4 - 6 Senior Shot, Javelin, Discus, Hammer Sprints, Hurdles Thursday Yr 5, 6, 7 Tuesday Yr 5, 6, 7 Y7 above

Membership Start

When would you like your membership to start?

As Soon As Possible (Yr8 and Older) Join the Waiting List (Yr7 and Below)

Preferred Start Date
(if applicable)

Membership Category

Please select your preferred membership category

	Category	Cost
	Previous members - Junior Members that were in the YCP and are no longer current and can't be deleted	£0.00
	U13 Waiting List Records interest and allocates a place on the BAC waiting list Only available to new applicants.	£0.00
	Secondary School Waiting List Records interest and allocates a place on the BAC waiting list Only available to new applicants between the ages of 12 and 18 inclusive.	£0.00
	Senior (over 18) Waiting List Records enquiry and notifies club of interest. For Athletes over 18 we aim to offer places as soon as possible, a trial period of two weeks will be followed by a membership offer. Only available to new applicants aged 18 or over.	£0.00
	Second Claim Those who train at another club but want to compete for Bracknell Athletic Club, as their first claim club does not provide the competition opportunity. The rate does not allow training at Bracknell a training membership is available on request.	£45.00

Data Protection

I understand that any personal data I provide on this site will be processed in accordance with the Terms & Conditions and Privacy Policy. I have read and agree to the Terms & Conditions (https://www.bracknellac.com/Home/TermsAndConditions) and the Privacy Policy (https://www.bracknellac.com/PrivacyPolicy;).

Signature

Date

Please return completed forms to: Mrs Jane Dave,

Use this form to send an email to another member. You may only send to one member at a time. Your registered email address will be passed on to this member but you may also include alternative contact details.

Note: Emails sent via the website are not entirely private. A copy of every email is held on the database and this can be accessed by the club officers using the Sent Emails page.

From

Alternative contact email

Another email address which the recipient can use to contact you.

Alternative contact details

Other contact details which the recipient can use to contact you e.g. phone number.

Subject

Message

Copy this message to my email address

Title

Description

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