Online Membership Application Form
After submitting the form, you will be taken to the payment page and may pay by credit card or debit card
I apply to join ELY RUNNERS - Please select "1st Claim" or, if you wish to retain main membership with another athletic club select "2nd Claim" ? 1st Claim 2nd Claim
Surname:
First Name:
Date of Birth (dd/mm/yyyy) e.g. 07/11/1975
Phone Numbers: Home
Work
Mobile
Email Address: Main
Secondary (if applicable)
Home Address:
Gender :
M F
For Juniors:
Parent/ Guardian contact info:
If different from any of the above.
Further Runner Info (optional):
Any relevant medical conditions you feel we should know about?
Unless notified to the contrary within 28 days, this application is deemed accepted by the Committee. Membership will be valid after confirmation of payment has been received. Membership enquiries to Richard Hill membership@elyrunners.co.uk
To confirm you have checked all the above details and that they are correct. Select below "Yes I confirm the details are correct" Please Confirm Yes, I confirm the details are correct (Use the "Submit" button below to send your form)