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Membership is £32.50 for under 21's (£17.50 if renewing)
It's now £40.00 for new members and £25.00 for current members.
Social Membership is £10 per year.

Please use the following details for paying via bank transfer:
Sort Code: 09-01-28
Account No.: 75229253
Please state your name clearly in the Reference.

Your Details

Please be aware that some Welsh Athletics events will require you to wear your club vest and not club t-shirt.

New Member's Name *

First

Last

Date of Birth *

Telephone number (Main) *

Telephone Number (other) *

Home Address

Health Questionaire

Please read the following questions carefully and answer each one honestly. Take your time and make sure you understand each question before you answer. If you have any questions please ask for advice.

Q1. Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? *

Yes No

Q2. Do you feel pain in your chest when you do physical activity? *

Yes No

Q3. In the last month, have you had chest pain when you were not doing physical activity? *

Yes No

Q4. Do you lose your balance because of dizziness or do you ever lose consciousness? *

Yes No

Q5. Have you had surgery in the past 6 months, if so give detail *

Yes No

Q6. Do you have a bone or joint problem that could be made worse by a change in your physical activity? *

Yes No

Q7. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or a heart condition or other serious illness. *

Yes No

Privacy & Data Protection Personal details are kept to keep you up to date with Caerphilly Runners or in the case of an emergency. By signing this form you are giving your consent for Caerphilly Runners to contact you, unless you have registered an objection by ticking the following box: Don’t worry, we promise we won’t bombard you with messages! *

Objection

An comments or questions? *

Club Membership - Sign up form

Your Details

Home Address

Health Questionaire

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