New Members Form Please ensure you have read the Code of Conduct and the Privacy Policy Title * Name * First Name Last Name Email * Phone * (###) ### #### Date of Birth * MM DD YYYY Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Membership Type * Annual Club Membership - £4 Annual Club Membership + EA Racing Licence - £23 Have you had a previous Athletics affiliation with a club in England, Northern Ireland, Scotland or Wales? * Yes No Provide England Athletics with your personal data which they will use to enable access to an online portal for you? * Yes You agree to the Code of Conduct * I agree You agree to the Privacy Policy * I agree You agree to the Disciplinary Policy * I agree Thank you