WESPA FIRE ATHLETICS - 2020 ATHLETE MEMBERSHIP FORM

VENUE: Bebington Oval Sports Centre
Tuesday's - Track / Outdoors: 6.30-7.30pm
Friday's - Indoor Sportshall: 7-8pm
Sunday's: Park/Beach Runs * times/venues confirmed by your group coach

Athlete's Name Athlete's Name * First Last
Please tell us the name of the athlete.
Athlete's Date of Birth Athlete's Date of Birth * / DD / MM YYYY

Please tell us the athlete's's date of birth.
Athlete's Name of School *

Please tell us the name of the athlete's school.
Athlete Membership *

Please select the athlete FLAME membership.
Athlete's Medical Conditions *

Please tell us of any athlete medical conditions we should be aware of. If no medical conditions then please type NONE.
THIS SECTION IS FOR PARENT INFORMATION
Parent 1 Name Parent 1 Name * First Last
Please tell us your/parent name.
Parent 2 Name Parent 2 Name First Last
If you would like to give us a Parent 2 name then please type it here. This is an optional field and not a requirement.
Parent 1 Email *

Please tell us your email address for all future communications.
Parent 2 Email

If you would like Parent 2 to also receive WESPA emails then please type an email address into this field. This is an optional field and not a requirement.
Parent Contact Telephone Number *

Please tell us your best contact telephone number for emergencies.
Parent 2 Contact Telephone Number

If you would like us to have a Parent 2 contact telephone number for emergencies then please type into this field. This is an optional field and not a requirement.
Address Address *
Street Address Address Line 2 City County Postcode Country
We may film and or take photographs during sessions and if so, do we have your permission to use the member's image(s) for official WESPA promotional material? *

Please select one of the drop-down options.
Spam Protection. Please answer this simple question.
What is "nine" as a number?
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Total

WESPA FIRE ATHLETICS - 2020 ATHLETE MEMBERSHIP FORM

WESPA FIRE ATHLETICS - 2020 ATHLETE MEMBERSHIP FORM

THIS SECTION IS FOR PARENT INFORMATION

£0

Total

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