Bobs Membership Form Page

Title *

Name *

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Last

Sex at Birth *

Male
Female

Date of Birth (DD/MM/YYYY) *

Address *

Please enter your address

Post Code *

Please enter your post code

Phone Number *

Please enter your phone number

Email *

Email

Confirm Email

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Emergency Medical Details - next of kin *

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Last

Emergency Contact Number

Please enter the number of someone we can contact in case of emergency

Medical conditions

Please enter any medical conditions we need to be aware of

New members only:

Aspirations & Goals

Membership type *

Members 18 & over - £50
1st Claim Transfer (EA FEE PAID) - £33
1st Claim Transfer (EA FEE PAID) Pensionable Age - £25
Family Membership for 3 (including children aged 9 or over in full-time education) - £117
Family Membership for 4 (including children aged 9 or over in full-time education) - £134
Family Membership for 5 (including children aged 9 or over in full-time education) - £151
Second Claim - £23
Members State Pensionable Age - £42
Non-Competing Coaches (UKA affiliation fee not applicable) - 1p
Associate Volunteer Membership - 1p

Paid by (please tick)... *

I agree to pay by card via the England Athletics Link This is the PREFERRED METHOD OF PAYMENT. (The club membership secretary will arrange for this link to be emailed to you. Please check ‘junk mailbox’ in case your mail server thinks this is ‘junk mail’) Important note - if you are paying for Family Membership, this can only be done by BACS (or Cheque) - see next tick box.
I have paid Membership Fee by BACS - Sort Code: 40 21 27 A/C 31085638 (please use reference “23/24 SURNAME”). ONLY USE THIS OPTION IF YOU ARE PAYING FOR FAMILY MEMBERSHIP, OR NOT WILLING TO USE A CARD FOR PAYMENT.
I do not have an online bank account or ability to pay online with a card. I have paid by Cheque (made payable to Fleet & Crookham AC and hand delivered to the club Treasurer or Membership Secretary).

Payment covers the period 1st April to 31st March the following year. Prompt payment is requested but if circumstances dictate the payment deadline is June 30th.

Please read the conditions of membership on the website and sign and date to signify your agreement *

I agree

Sign and date (type name and date before submitting form) *

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Date (DD/MM/YYYY) *

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Find Us

Address

Fleet and Crookham AC
Peter Driver Sports Field
Behind Tweseldown Pub
Bourley Road
Church Crookham
Fleet, Hants
GU52 8DY

Club meeting times are:

Tuesday/Thursday evenings and Sunday mornings at the Peter Driver sports field, Bourley Road

Wednesday evenings – Aldershot Military Stadium

For more detail see the contact page