Contact Us

Chairman - Paul Hawkins

( 01789 842681

chairman@stratfordac.co.uk

Membership Secretary - Lesley Kirk

( 01789 261980

membership@stratfordac.co.uk
Stratford upon Avon Athletic Club
 
This is page 1 of 3 for full and coach junior membership. Full-time student membership (18+) is via our seniors membership form

Please enter your details and then click on Submit to go to page 2 where you will be able to check your details. Please enter in Title Case.

You will be able to pay online via PayPal on page 3.

*mandatory field

Junior Membership Form

Personal Details
*First name:   *Last name:  
*Address (line 1):  
Address (line 2):

 
*City:   *County:  
*Post code:  
Home tel.:   Mobile tel.:  
*Email:  
*Date of birth:   *Gender: MaleFemale
Sibling at club? Sibling Name:  
*School name:   *School year:  

Medical Information
Do you have a medical condition?
Medical condition details (e.g. asthma, epilepsy, diabetes etc.):

Emergency Contact Details
*Contact name #1:  
*Contact tel. #1:  
Contact name #2:  
Contact tel. #2:  

Disability
The Disability Discrimination Act 1995 defines a disabled person as anyone with 'a physical or mental impairment, which has a substantial and long term adverse effect on his/her ability to carry out normal day-to-day activities'

Do you consider yourself to have a disability?
Disability details (e.g visual impairment, physical impairment, hearing impairment, learning disability etc.):

*Declaration
I agree to my son/daughter/child in my care taking part in the activities of the club.

I understand that I will be kept informed of these activities - for example timing and transport details.

I understand that in the event of injury/illness, all reasonable steps will be taken to contact me and to deal with that injury/illness appropriately.
*Name of parent/guardian:  

Type of Membership
Type of membership: