Membership Form

We are affiliated to Triathlon England, England Athletics.org and Cycling Time Trials

Membership Fees from 1st April 2017

Please read and select carefully – if you do not include the additional UK Athletics affiliation, you will not be able to run as a first claim member for Tri-Logic Cornwall.

Joining 1st April and 31st December without UKA £25
Joining 1st April and 31st December with UKA £38

Joining between 31st December and 31st March  without UKA £15
Joining between 31st December and 31st March with UKA £28

membership form 2017-18

1. Membership requiredPlease select membership requiredFull membership £25Full with England Athletics £38(required)
2. Full Name(required)
3. Genderplease selectmalefemale(required)
4. Date of Birth(required)
5. Address(required)
6. Postcode(required)
7. Email address(valid email required)
8. Telephone no.(required)
9. Mobile(required)
10. Current membership no.(required)
11. Member of any other Athletics Clubplease selectyesno
12. 1st or 2nd claim memberplease select1st claim2nd claimHonorary
13. England Athletics Reg no. (if known)
14. Your health is your responsibility, but please let us know if you have any medical conditions/ take any medication/ have any allergies that we should be aware of:
15. The information you provide here will be included on your membership card, and will be usd in the event of an emergency. You will need to bring your membership card to every club training session(required)
16. Emergency contact details:
17. In the event of an emergency, please provide contact details of a family member or friend.
18. Full Name(required)
19. Relationship(required)
20. Mobile Number(required)
21. Land-line Number(required)
23. I confirm that I understand that participation in Tri-Logic Triathlon Club activities is entirely at my own risk, and that no resposibility for any injury sufferd by me shall be attached to Tri-Logic Cornwall - we recommend that you join British Triathlon www.britishtriathlon.org or British Cycling www.britishcycling.org to cover your Public Liability in the event that something should happen to you during a club ride or race.
25. I give permission for you to display my contact details on our membership list (for internal club use only) and I agree to the use of photos of club activities for promotional and reporting purposes only, and on the club website.
26. Signed:(required)
27. Date:(required)
28. Payment can be made online using the following details:
29. Sort code: 30-98-76 Account number: 01586157 - please use reference 'membership' when paying online.
30. Payment methodplease selectChequeBACScashother(required)
31. If paying by cheque please make to Tri-Logic Cornwall and send to:-
32. Kevin Williams, Sleepy Hollow, Roscroggan, Camborne
33. TR14 0JA
34. CAPTCHA