Online Membership Registration Name (including title)* Full address (including Postcode)* Email* Telephone Number* Date of birth* Gender* EA Number (if known) Country of birth* Nationality* When you become a member of or renew your membership with Malvern Joggers 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. England Athletics will contact you to invite you to sign into and update your MyAthletics portal. If you have any questions about the continuing privacy of your personal data when it is shared with England Athletics, please contact email@example.com. Do you grant to Malvern Joggers the right to use any photos official or unofficial that are available in the public domain that they can be used for example such purposes as publicity, illustration, advertising, and Web content. The publicity officer will of course use his discretion and not publish anything they feel to be unsuitable. I consentI do not consent Do you permit your e-mail address to be used to send you regular club information. It will not be disclosed to third parties. I consentI do not consent Membership is £25 a year which includes individual affiliation to England Athletics (EA). If you are already affiliated to EA through membership of another club you can opt for 2nd claim membership at £10 per year. The Membership year begins on 1st January. By signing and returning this form, I understand and accept that: I have read, understood and agree to the running disclaimer on the website (http://www.malvernjoggers.co.uk/disclaimer) Standard (1st claim) membership: This includes UK Athletics affiliation fee of £15, which entitles you to many benefits, including reduced race entry fees, eligibility to run in cross country leagues and discounts from many sports shops. 1st claim renewal £251st claim new application £252nd claim renewal £102nd claim new application £10 If you wish to pay via BACs, our details are – Bank: HSBC | Sort Code : 40-31-45 | Account No: 20005460 | Account Name: Malvern Joggers. Please use your full name as your reference to ensure easy identification of your payment. Please leave this field empty.