Note: text can be typed into the boxes on the form before printing
Fenland Running Club.
Application for Membership.
Surname
Forenames
Address
 
 
County Post Code
E-mail address          Phone   
Date of Birth
First Claim
(if not Fenland)
 

I apply for individual / family membership of Fenland RC and declare:

  • I am an amateur as defined by the ruling body of Athletics.
  • I am medically fit to undertake strenuous exercise.

or    (delete as appropriate)

  • I suffer from the following condition / have been prescribed the following medication


                         ________________________________________________

             though my doctor agrees I am fit to undertake strenuous exercise.
Signed .......................................................... Date ..................................

Please give or send this form, with your  subscription of £15 ( £20 family), payable to Fenland RC,

to

Geoff Floyd at 3 Salgate Farmhouse, Islington Rd., Tilney-cum-Islington, Kings Lynn PE34 4RY