Membership Form

About you
Name *
Address *
Date of birth *
Date of birth
If London, please be specific e.g. Guys Hospital
Are you currently a member or have you previously been the member of another athletic club (Not applicable if joining 2nd claim) *
Date of resignation
Date of resignation
Have you submitted to Change of 1st Claim Club Form?
Medical information
Do you have any medical conditions which our coaches and team managers should be aware of?
Disability awareness
Do you consider yourself to have a disability? *
If yes, what is the nature of your disability?
Athletic Participation
Please tick areas of special interest *
Emergency contact details
Name of first emergency contact *
Name of first emergency contact
Name of second emergncy contact *
Name of second emergncy contact
Type of membership
Hardship Cases: Gmax Trackstars wishes to encourage as wider participation in athletics as possible. The club would not want anybody suffering significant financial hardship to be prevented from participation in the sport. The club will apply a 75% reduction to the membership fee, but members must pay their respective England Athletics Registration Fee. The reduction can be accessed by approaching the membership secretary with evidence of the financial hardship being suffered. Each application will be judged on its own merits and in confidence.
Declaration of applicant
I apply for membership to Gmax Trackstars and, if elected agree to abide by the Constitution of Gmax Trackstars and the Club Code of Conduct. (Constitution; Code of Conduct can be found on the club website) *
Parent/Carer Authority
(Only applicable if applicant is under 18)
I do hereby certify that the details supplied under Sections A to F above are correct to the best of my knowledge. I consent to:
Name of parent/carer who is granting consent
Name of parent/carer who is granting consent
Date consent given
Date consent given
Parent/carer help
One of the conditions of membership of Cambridge Harriers is that we ask all parents/carers to help at club events for a few hours each year. Please tick areas that you would be interested in helping with

When you become a member of or renew your membership with Cambridge Harriers you will automatically be
registered as a member of England Athletics. We will provide England Athletics with your personal data which they
will use to enable access to an online portal for you (called MyAthletics). England Athletics will contact you to invite
you to sign into and update your MyAthletics portal (which, amongst other things, allows you to set and amend your
privacy settings). If you have any questions about the continuing privacy of your personal data when it is shared with
England Athletics, please contact