Wight Tri Membership Application

Data protection: The details on this form are held as part of the club records and allow the club to contact members with club updates and mailings. The Club does not pass on details to outside organisations.

Membership fees are paid by standing order, online via your own bank account. Please use your name as a reference. The club bank details will be emailed to you once your application is accepted.

If payment using this method is a problem for you then contact the membership secretary.

Name*
Address 1
Address 2*
Address 3*
Post Code*
Date of Birth*

MM
/
DD
/
YYYY
Gender
Male 
Female 
Unsure 
Email*
All club communication is via email
Phone
Please contact me about news and events*
Yes 
No 
Emergency contact name
Emergency Contact Number
Membership Option
Adult full year - £10 
Adult full year plus UKA registration - £15 
Membership runs for a full year starting on the 1st October.UKA registration entitles you to a £2 discount on all UK Athletics endorsed running races,
Additional Information / Profile
Please provide details of you sporting background, what your goals are for this year and any interesting information you want to share.
I can help the club because I am
a qualified first aider 
a qualified coach 
a qualified race referee 
willing to organise a duathlon 
willing to organise a social event 
willing to help marshal west wight triathlon 
Declaration*
I agree to the club rules as set out in the club constitution including the code of conduct. 
I accept that participation in club events at my own risk 
Feedback
Please provide feedback on the club and how we can improve
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