Register

Membership starts on 1st April and is valid until 31st March 2021.

Membership

Membership Type (pre 2020)

Membership Type *

Individual Training

Family

Student

Non-training

ITRC

Over 65s

Individual Training

Family

Student

Non-training

ITRC

Over 65s

Primary Applicant

First Name *

Last Name *

Date of Birth *

Date of Birth format: DD/MM/YYYY

Gender *

Address

Street *

Optional

Town *

Postcode *

Contact

Phone Number *

Mobile Number

Email Address *

Medical Information

Please list any medical condition or any known allergies (including allergies to medication) which might affect your running. *

Please enter NONE if no medical conditions

Emergency Contact

Name *

Telephone Number *

England Athletics Race Licences

The subscription rates include the cost of an EA race license. To be eligible for affiliation discounts on races, you must hold a valid Personal EA Licence. Typically, each UKA sanctioned race would attract a reduced entry fee by £2 with a valid EA licence. A valid license is required for certain races, including events qualifying for county medals. Licences are valid from 1 April - 31 March.

If you do not wish for your membership to include an EA licence, please indicate which applicants do not wish to have an EA licence. Your subscription cost will then change to reflect this decision.

EA licences can be purchased separately at a later date if preferred.

EA Licence

I do not require an EA Licence

Running Affiliation

Claim

EA Licence Number

Witham Triathlon

Yes

No

Triathlon is adults only

Profile

Profile Photo

Maximum upload size: 2MB

Additional Family Applicants

Additional Applicants

I would like to add additional family members to my application

An additional consent form is required for each junior running applicant.

Same Address *

I confirm that all family members live at the same address as the Primary applicant.

Additional Family Applicants

Additional Applicant

First Name *

Last Name *

Date of Birth *

EA Licence

I do not require an EA Licence

Claim

EA Licence Number

Witham Triathlon

Yes

No

Triathlon is adults only

Please list any medical condition or any known allergies (including allergies to medication) which might affect their running. *

Please enter NONE if no medical conditions

EA Licence Counter

Add Member Remove Member

Additional Applicants

I would like to add additional members to my application

Additional Applicants

Additional Applicant

First Name *

Last Name *

Date of Birth *

Applicants address is: *

Same as my address

Different to my address

Street *

Optional

Town *

Postcode *

EA Licence

I do not require an EA Licence

Claim

EA Licence Number

Witham Triathlon

Yes

No

Triathlon is adults only

Please list any medical condition or any known allergies (including allergies to medication) which might affect their running. *

Please enter NONE if no medical conditions

EA Licence Counter

Add Member Remove Member

Club London Marathon Ballot

To be eligible for our club 2021 London Marathon place draw, members must have paid fees for the 2020/2021 year by the 30 April 2020 in addition to fulfilling the remaining criteria as described in the Club Constitution.

England Athletics Race Licences (Family)

England Athletics Race Licences (Non-Family)

England Athletics Race Licences (Not Required)

EA Licences Total

Membership

Additional Applicants

Total

Payment

Total Payment Due *

Credit Card *

Please take a moment to read our declaration and policies

Declaration

I agree to abide by the Club constitution, and all associated policies and codes of conduct.

I declare that I am / we are medically fit and able to participate for Witham Running Club and take personal responsibility for our own health when involved in Club activities.
I declare that I am / we are personally responsible for our own safety when involved in Club activities.
I agree that Witham Running Club or its officers may not be held liable for any discomfort or injury that I / we may suffer resulting from Club activities.

Equality and Diversity Policy

All individuals, regardless of ability, background, race, religion, gender, age, preferences and personality are of equal worth and are welcome as members of our Club and, once accepted as members, have all the advantages, respect and facilities that our Club and its members can offer.

Our data privacy notice

When you become a member of or renew your membership with Witham Running Club, we will collect certain information about you which will include your name, date of birth, gender, address, phone number, email address, medical information affecting running (member data).

We will use the member data in relation to the calculation of relevant awards such as the club championship, club standards, and club records. Member data may also be used to submit team entries for certain events which require some of this information. We will use your email address to send you regular summaries of information posted to the website and other bespoke communications. We may use your phone number if there is a need to contact you. Your information about medical information affecting running is shared with the coaching team only, so that they are able to better respond to any situations which may arise in relation to those medical issues.

Other than England Athletics (see below), Witham Running Club will not share your information with any other party, without seeking your further prior consent. If you have any questions about the continuing privacy of your personal data, please contact membership@withamrc.org.uk.

EA’s data privacy notice

When you become a member of or renew your membership with Witham Running Club you can choose to be registered as a member of England Athletics (you will have to register with England Athletics if you ever compete for the club under the UKA rulebook). If you tick the box below 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 dataprotection@englandathletics.org.

Consent *

Please tick this box to agree with how your member data will be used.

Membership

Primary Applicant

Address

Contact

Medical Information

Emergency Contact

England Athletics Race Licences

Running Affiliation

Profile

Additional Family Applicants

Additional Family Applicants

Additional Applicant

Additional Applicants

Additional Applicants

Additional Applicant

Club London Marathon Ballot

Payment

Please take a moment to read our declaration and policies

Declaration

Equality and Diversity Policy

Our data privacy notice

EA’s data privacy notice

Our Races

Club Results