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Southampton Running Sisters Beginners’
Course Application Form
*** Southampton
Running Sisters Beginners Application Form 2008
***
Name:
Address:
Post
Code:
Telephone:
(daytime)
Telephone: (evenings)
Email:
Emergency Contact
Name: Telephone:
What is your
running experience?
Beginner ...
Some experience ... Active in another sport ...
Have you ever
belonged to another running club?
Are you currently a
member of another running club?
If so please name
it here
Medical
information: Please write down ANY medical condition
Southampton Running Sisters should be
aware of e.g. back/knee injuries, high blood pressure, diabetes,
asthma
...................................................................................................................
Your date
of birth
................. (NB over 18 only)
PLEASE READ THE
FOLLOWING CAREFULLY AND SIGN BELOW.
I ACKNOWLEDGE THAT
IN PARTICIPATING IN THIS COURSE I WILL NOT HOLD
Southampton Running Sisters liable
for any injury I might sustain. I undertake that I am enrolling on this course in
good health at my own risk. I understand that the course will be
assisted by qualified coaches and helped by other Running Sisters. I
confirm I am over 18.
SIGNED
........................
Date...............
I wish to enrol on
the Running Sisters Beginners’ Course
I enclose an
advanced registration fee of £30 full
fee/£25 concessions*
* only cheques (payable to Southampton Running
Sisters) or Postal Order – no cash by mail, Receipts
will be available at registration
Please return the completed form by post (fee
enclosed) to:
Tina Dempster, Membership Secretary,
15 York Close, Horton Heath, Eastleigh SO50
7PX
NB: registration on the first day £35,
Enclose an SAE for acknowledgment if you do not have email.
1. Membership
