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Membership Registration 2015 / 2016
Membership year begins 1st May to 30th April
Full Annual Membership
Cross Country Membership
Last Quarter Membership
21 & Under Full membership
LFR EA Membership
£25.00
£15.00
£12.50
£15.00
£12.00
(Compete in XC races only. You do not have to pay if you have full membership.)
(1st Feb – 30th April)
England Athletics affiliation fees are £12.
By having EA affiliation you consent to allow LFR to provide your details to EA officials.
EA Affiliation allows entry to EA affiliated races without having to pay additional unattached levy.
Please tick if you DO NOT consent to being attached to LFR. Your membership will be £25.00 (£15 if 21 or under)
Bring along completed form & cheque on
Tuesday club night or post to:
Mariam Allen
45 Johnson Drive
Leighton Buzzard
LU7 4RT
Cheques made payable to Leighton Fun Runners
Alternatively transfer fees using your name
as the reference to:
HSBC
Sort: 40-28-12
Account: 41097466
Name
Address (with postcode)
Telephone
Emergency Contact
Name/Number
Email Address
@
Date of Birth
Data will be recorded for use within the club only. It will not be shared with any external agencies other than England Athletics.
Disclaimer
I hereby declare that Leighton Fun Runners will not be liable for any injury or loss/dame of personal property.
Signed.............................................................................................................................. Date..............................................................