Athletes Full Name: (required)
Date of Birth: (required)
Name of GP: (required) GP Phone No.: (required) Details of any known conditions, allergies, etc. (e.g. asthma, diabetes, epilepsy) and any medication being taken:
Parent/Guardian’s Full Name: (required) Gender: (required) MaleFemale
Relationship to Athlete: (required) Mobile Phone No: (required) Email: (required)
Parent/Guardian Address: (required)
The Parent/Guardian listed above will be our primary contact in the event of an emergency involving the athlete. We would strongly urge you to provide details of an additional person that we can contact if needed.
Secondary Contact Name: (required) Relationship to Athlete: (required) Mobile Phone No: (required)
Has athlete ever been a member of another Athletic Club?: (required)
YesNo
If yes, name of Club: Date Membership Elapsed:
As a member of Rathcoole Athletics Club…...
I agree to have fun, make friends and learn about athletics from my coaches and mentors.
I agree to train to the best of my ability, and represent the Club in competitions.
I agree to accept coaching from the Club and to behave in an appropriate way at all times.
I agree to help out and take part in fundraising activities for the Club.
I agree to the Rules of the Club, and the ‘Codes of Conduct’ from Athletics Ireland (available on request).
During the time your child will spend with us photographs may be taken for the Club social media channel and general Club purposes, for this we need your permission. Please note that we will never tag any child/parent or disclose any personal details. Whilst every reasonable precaution is taken to ensure the safety of all athletes and members, Rathcoole Athletics Club, its coaches and/or officers will not accept any responsibility for loss of property and/or injury suffered during training, competitions or any Club activities. • If you cannot be contacted in the event of illness, you give permission for medical treatment to be administered where considered necessary by a nominated first aider or by suitably qualified medical practitioners. • If you cannot be contacted and your child needs emergency hospital treatment, you authorize the calling of an ambulance and a qualified medical practitioner to provide emergency treatment or medication. • You agree to pay Club fees in a timely manner, and accept that if fees remain unpaid, the Athlete will not be permitted to remain a member of Rathcoole Athletics Club. • You agree to the Rules of the Club, and the ‘Codes of Conduct’ from Athletics Ireland (available on request).
By ticking this box, you have given agreement and permission for the above actions to be taken.
By ticking this box, I consent to Rathcoole AC gathering and securely storing the personal data contained in this Club membership application, which will be retained and destroyed in accordance with the Club Privacy Statement.
Rathcoole Athletics Club is run by members on a volunteer basis. If you are interested in volunteering on either a continuous, or a once-off basis, we would be delighted to hear from you.
Please indicate your interest below:
Coach / Assist:
Fundraise, etc:
