Membership
Form 2007
Name: Nickname:
Age: DoB: M / F
Address:
Parent Contact:
Phone Number:
e-mail:
School:
PE Teacher:
Favourite
Athletic Events (please circle):
Running (sprints) Running
(Middle Distance) Cross
Country
Long/Triple Jump High
Jump Sports
Hall Athletics
Javelin Discus Shot
Hammer Pole
Vault Multi-events
Walking Fell
Running Triathlon
Other Sports
Played
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Normal Weekly
Activities Timetable (eg, PE lesson, swimming club,
dancing, etc):
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SUN |
MON |
TUE |
WED |
THU |
FRI |
SAT |
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Health
conditions (eg, asthma, etc):
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Are you
registered disabled?
Ambitions in
Athletics (eg, fitness, fun, County standard,
Olympics):
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Personal Bests
/ Proudest Achievements:
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Cultural /
Lifestyle Details (eg, religious beliefs, diet, dress
code, etc):
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Signed: Date:
Parent:
Parental Photograph
Consent
We are asking
your permission to take and use photographs for the purpose of updating the Juniors applications and want to cover everybody in reports
when they are racing. Some photos could be used for different websites such as
BOFRA, FRA and K&CAC.
I give permission for photographs of
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to be used mainly
for the K&CAC website.
Signed:
.
Date:
..