San Domenico RC Membership Form 2026/27

Thanks for your interest in joining San Domenico RC. Welcome! Please complete the form with your details and click 'submit'. Thank you!

First name

Last name

Home Address

Phone Number

Date of Birth (day/month/year):

Sex:

The following relates to your eligibility to compete for a Welsh region or a Welsh national team:

Are you Welsh?

If you are already a member of a UK Club, please provide a) the name of the club, b) (whether its a first or second claim) and c) the date you resigned from the club:

DISABILITY/MEDICAL INFORMATION

Do you consider yourself to have a disability? If so, please advise the nature of your disability? Relevant medical information e.g. asthma. If no, please enter 'N/A' or leave blank:

Please state any medication (enter N/A or leave blank if none):

EMERGENCY CONTACT DETAILS. Please include a name and tel no:

DECLARATION

I declare that the information given is correct and that I agree to abide by the rules of the club and the club constitution. I declare that I am an amateur as defined by UK Athletics rules and that I will abide by these rules. I am medically fit and understand that I participate/enter in any club activities/events entirely at my own risk. I agree that San Domenico R.C. shall not be liable for any accidents, injury, loss, damage or claim or expense that may arise in consequence of my participation in club activities/events. I accept that my personal data will be held on a computer by the club and agree to the diclosure of such data in a list of members and to Welsh Athletics.

Your Signature

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Date submitted

UKA / WA Anti-Doping Policy

By becoming a member of the club, you are automatically agreeing to the codes of practice as stated by Welsh Athletics- this relates to the codes of conduct, to the rules of UK Athletics and to adhere to all anti-doping regulations.

All members shall be deemed to have made themselves familiar with and agreed to be bound by the UKA Anti-Doping Rules and to submit to the authority of UKA Anti-Doping in the application and enforcement of the Anti Doping rules.

PHOTOGRAPHY & SOCIAL MEDIA CONSENT:

Please let us know if you do or do not wish any photograph or videos of yourself being used on the club's social media platforms; (eg Facebook), please select an option here:

MEMBERSHIP FEES

Included in the membership fee is affiliation to Welsh Athletics (£25) which typically saves you £2 per race entry fee. As a member you will need to purchase a 'club vest' -these are available in ladies and mens sizes; (XS- XL) at a cost of £15 for the first one and £23 for each subsequent one.

Summary - Employed Membership Fee - £47, Students/Unemployed Membership Fee - £25

PAYMENT

Payments by BACS to: San Domenico RC SORT CODE: 23-05-80 ACCOUNT: 54466087 METRO BANK Senior (20+) £47 per year - this includes mandatory membership of Welsh Athletics (£25). Students/Unemployed £25 per year. Social / second claim membership fee £10 per year. Please can you email membershipsandomenico@gmail.com once you've made payment.

(YOU DO NOT NEED TO FILL IN ANYTHING HERE) - THIS IS FOR CLUB INTERNAL USE:

Proposer (commitee member):

Seconder (commitee member):

Have you made a note of the club's account details to make payment?

Yes, I've made a copy , it's in safe hands

Doh! Let me screenshot it/make a copy now

INTERNAL USE ONLY :- Date elected to the club: