White Rose Triathletes

White Rose Triathletes - Senior Membership Form

Cost for Seniors - £15 per year (both 1st claim & 2nd claim)
All boxes marked with a * are compulsory

* First Name
* Surname
* Address
Address
Town
* Postcode
Telephone
Mobile
* E-mail
* Gender
* Date of Birth

* Next of Kin
* Contact Telephone

* Medical Issues
If Yes, Please Give Details

* Type of Membership º
If 2nd Claim, What is your 1st Claim Club?
* Do you agree to abide by the rules of White Rose Triathletes ºº Tick box to agree.
Please ensure all details are correct. After pressing submit you will be automatically re-directed to the secure payment area (Paypal) Follow all instructions on the payment pages.

Notes
º	1st Claim membership = Full membership 2nd Claim membership = Limited to members of other tri clubs who are in the area due to work / education reasons.
ºº	The rules of White Rose Triathletes as laid out in the clubs constitution are:-

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