Registration 2018 - Dunleer AC

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Registration 2018

Registration

Registration form below - Please print off

Dunleer A.C. Membership Form 2018



Membership Fees includes insurance
Senior: €60 Junior: €40  Fit4Life Membership: €40   Families: €125
Juveniles:
1st child €40; 2nd child €30; 3rd and subsequent children €20.

Juvenile members may be represented at the AGM and any EGMs by parents/guardians.
Voting rights exist for fully paid members only i.e. €60.  


All new members (never registered with AAI previously) need to submit a copy of their Birth Cert

Further information from:  
Registrar:      Karen Costello  
Club Secretary:   Hugh Hodgins
Club PRO:   Jacqueline Matthews


Name:     

______________________________

Date of Birth:   

______________________________

Contact number(s):  

______________________________

email address:  

______________________________


Postal Address:    
______________________________

______________________________

______________________________



Any health conditions we should be aware of:


_____________________________________________________________________

I agree to abide by the Rules and Constitution of Dunleer Athletic Club & the Athletic Association of Ireland.
I agree to notify the relevant coaches as soon as possible if I develop an injury or illness.
I agree to the use of my photograph in Dunleer AC newsletters and newspaper reports.
I agree to the use of my photograph in the Dunleer AC website and I understand that my personal details will not be given.


__________________________           _______________________________________
Signature of Athlete                              Signature of parent/guardian (if athlete under 18)


Date: __________________




Chairman: David Carrie                            Secretary: Hugh Hodgins

Club Website: www.dunleerac.net
 Dunleer AC Facebook Page


 
 
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