Membership Application

New member fees for 2021 are:

  • Full Rate £45.00
  • Concessionary rates £30.00
  • Second Claim £30.00

Concessionary rates apply for First Claim Students, Unemployed and State Pensioners.
First claim fees include the registration charge levied by England Athletics. All fees include a Club vest.

Note: To use the facilities at the Jaguar Sports and Social Club, eg toilets, showers, car park and the Social Club bar you must take out Social Club Membership, paying the additional fees as determined by the Jaguar Sports & Social Club.
Complete the form below and we will email you with payment instructions when we have received your application submission.

If you have a question, refer to the FAQ page of our website or contact us via the contact page.

    Please note: This form is for new membership applications only. If you wish to renew your existing membership please complete the Membership Renewal Form.
    All fields are to be completed.

    Gender
    malefemale

    Next of kin, or person to contact in case of emergency
    (This is optional but if not given Club accepts no liability)

    County of birth
    (Counties are defined as pre-1974 boundaries (i.e. Warwickshire includes Coventry, Solihull and Birmingham)

    If resident in Warwickshire (as defined above), have you had continuous bona fide residency for at least nine months? If not, state date of moving into the County.

    YesNoN/A

    Are you, or have you ever been, a member of another running club?
    YesNo

    Is Northbrook to be your 1st or 2nd claim club?
    (Unsure? see First claim/Second claim definition).
    1st claim2nd claim

    What First Claim class of membership are you applying for?

    Full rate £45Concessionary rate £30

    What concession are you applying for?

    State pensionerStudentUnemployed

    You are applying for Second Claim membership

    Standard rate £30

    Your joining membership fee includes a club vest
    Please select below your preferred size.

    XSSMLXLXXL

    I have read and will abide by the Club Rules.
    I declare that I am an amateur, as defined by the Rules of the Governing Body of athletics.

    I declare that I am medically fit to take part in the activities provided by Northbrook AC. I participate in the Club's activities at my own risk and agree that Northbrook AC will not be held responsible for any injury, accident, loss or damage consequential to my participation.

    By applying for membership I consent to my personal data provided on this form being held by Northbrook Athletic Club and used for the purposes of club membership management and communications and, if I am a first-claim member, my name, address, telephone number and date of birth being provided to England Athletics for competition registration and insurance purposes.
    Learn more about how we process and protect personal data by reading our Privacy Policy.

    Would you like us to add your email address to the Northbrook AC mailing list?
    You can then receive mailings about Club activities, events and news. You can unsubscribe at any time.

    Yes pleaseNo thanks
    When all fields are completed select Submit once only and await a response message.