Membership Application Form Your Full Name (required) Your DOB (19/12/1969 format) (required) Your Full Address (required) Your Post Code (required) Home Telephone (required) Work Telephone (optional) Mobile Telephone (required) Your Email (required) Emergency Contact Info (optional) Any relevant medical conditions that we should be aware of for your safety (optional) Details of any other current running club memberships (first/second claim etc) (optional) Please write 'I AGREE' in the box below * By writing 'I AGREE' and submitting this form I apply to become an ordinary member of Knowle & Dorridge Running Club and declare that the information above is correct. I agree to abide by the terms of the club’s constitution and any other additional rules and requirements of the club's management. I understand and agree that 1) I will run with the club and participate in any events entirely at my own risk and that I must undertake personal care and responsibility for my own health, fitness and for any of my property. 2) the club and or its management or its leaders will not be legally responsible for any proven injury, loss and or damage sustained by me to my person or to any property however caused even if by negligence – except that liability will be accepted only for personal injury to me in circumstances where it can be established in law that the club and or its management and or its leaders have been negligent. The club constitution, any additional rules and requirements of the club management, the current annual fee for membership together with details of the club’s officers, are all published on the club’s website. Please contact the Membership Secretary for clarification of the fee if you join part way through a club year. Membership fees can be made by electronic bank transfer to our account (details available from the club treasurer) or cheques payable to Knowle and Dorridge Running Club can be sent for the Attention of The Membership Secretary, Knowle & Dorridge Running Club, P O Box 16490, Solihull, B90 9HS.