Renew Membership Form

Membership type
- Individual Adult Membership
- Under 18 / Full Time Education Membership
- Under 11 (Must be 9+ to join)
- State Pension Age
- Associate / Active Coach
- Second Claim Member (EA fee not included)
- Student*
* Full time or further education at University or College more than 20 miles away from Mansfield, and unable to attend regular training sessions.
Privacy of your data*
Review our privacy policy to read more about how we protect and manage your data.
- I consent for Mansfield Harriers & AC to collect my name, email address, telephone number, postal address, date of birth, any given medical conditions and first aid training/qualifications.
Athletes, Parents and Coaches Code of Conduct*
Review the England Athletics Club Safeguarding & Welfare Policies and read how It is everyone’s responsibility to protect the welfare of all those who participate in athletics.
- I have and read and will adhere to the policies
Under 11's Parents*
As a parent/guardian of an under 11 athlete I acknowledge I must be present with them during training.
- I have and read and agree to this
Road Adult
Price:
Road Under 18
Price:
Under 11
Price:
State Pension Age
Price:
Road Coach
Price:
Road Seconds
Price:
Student
Price:
Current Total
£ 0.00

1. Photographs*
Do you give permission for Mansfield Harriers & Athletic Club to take photographs and videos of your son/daughter at athletics events and training sessions by a coach for training purposes or to use them on the Mansfield Harriers & Athletic Club website and other promotional material (e.g. local newspapers)?
- Yes
- No
2. Transport*
Hire transport will be provided to certain events during the year. If required, do you give your permission for your child(ren) to travel on this transport? (Limited space may be available for parents).
- Yes
- No
Parent/Guardian Signature
If on a touch screen device simply sign with your finger, on a desktop computer click and sign.
Parent/Guardian Name
Full Name
Date
Current Total
£ 0.00

Stripe Surcharge
Price: £ 0.00
Current Total
£ 0.00
Please enter your card details in the form below and click the join button to make payment, please remember there is a additional 1.5% +20p charge for using Stripe.
Credit Card Details*
Cardholder Name
Cardholder Name