Membership Form

Membership form (click here to download)

Woodthorpe Huffers and Puffers

We are very pleased to welcome you to the Woodthorpe Huffers and Puffers.

To ensure we have the correct contact details for you, please download and complete this form and give it back to Margaret Deeny-Harriss with your membership fee.

Please note you must be over 18 to be a member of Woodthorpe Huffers and Puffers. Runners under 18 are welcome but must run with parents/guardians.

Name

Address

Postcode

Home telephone number

Mobile*

Email*

Date of Birth

Medical information

Please detail below any important medical information that our jog leaders should be aware of (e.g. epilepsy, asthma, diabetes etc.)

Emergency contact details

Please insert the information below to indicate the person(s) who should be contacted in event of an incident/accident.

Contact name

Emergency contact number

I understand in the event of injury or illness all reasonable steps will be taken to deal with that injury/illness appropriately.

I agree that photographs taken of me by the club can be used for the purposes of Woodthorpe Huffers and Puffers publicity

Name:

Signature: Date:

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