Membership Form

Title

First name

Last name

Registered Gender at Birth

Date of Birth

Email

Multi-line address

Country/Region

Address

City

Zip / Postal code

Phone

Membership Type

Emergency Contact Name

Relationship to Above

Emergency Contact Phone

Running Ambitions

We’d love to get to know you a bit better! What are your goals for joining the running club? Whether you're here to improve your fitness, train for a race, meet new people, or just have fun, we'd love to hear about what you're hoping to get out of your time with us.

Please let us know if you might be interested in joining the club for any of the following

Weekly group runs (various paces welcome)

Couch to 5K or beginner-friendly sessions

Social run-walks or jog-and-chat sessions

Track sessions or speed play (no pressure!)

Monthly social nights (pubs, dinners, quiz nights)

Volunteering together (e.g. parkrun, charity events)

Road races (5K, 10K, half marathon, marathon)

Cross-country races

Trail races / fell running

Medical declaration

I confirm that, to the best of my knowledge, I am medically fit enough to take part in running and running-related activities organised by Telford Harriers. I understand that I participate at my own risk.

I agree to inform a run leader of any medical condition, injury, allergy or other health issue that may affect my participation or may require assistance in an emergency.

GDPR Consent

Yes

No

I consent to my personal data being stored and used for the purposes of contacting me about club-related activities, in accordance with the GDPR.

Promoting the Club

Yes

No

I give permission for photographs of me taken during club events to be used in promotional materials and on social media to advertise the club.

Page Title

Est 1984

Medical declaration