Membership Form Online | Bicester Athletic Club

Bicester AC Membership Form

Step 1 of 6

Bicester AC Membership Form 2026 - 27
Section A: Members Details.
I am a:*
Member's Full Name*
First Middle Last
I am a:*
(select all applicable)
- Athlete
- Coach
- Young Leader
- Technical Official
- Committee Member
- Volunteer
- Adult Member
England Athletics URN Number (if known)
What is the members gender?*
Address*
Street Address Address Line 2 City County Post Code
Phone (Landline)
Mobile No (parent's if under 16 years of age)*
Date of birth*
Day
Month
Year
County of birth*
The county the athlete was born in i.e. Oxfordshire
Email (parent's if under 16 years of age)*
Current school year*
Current School*
Are you a member of any other sports club?*
Please state which club and which sport:
First or Second Claim member
If you are a member of another club affiliated to England Athletics then you will be a second claim member. If your other club in not affiliated to England Athletics you will be a first claim member.
Preferred Events (if known);

Section D: Medical Information.
Does the member have Asthma?*
Does the member have an inhaler?*
Will they have it with them at training and or competitions?*
Does the member have any Allergies?*
Please list their allergies.*
Does the member have an EpiPen?*
Does the member have learning difficulties (ADHD, SPD, etc.)?*
Please list their learning difficulties and any additional information we need to know.*
Other medical details:*
Please give details of any other important medical information that our coaches / young leaders should be aware of (e.g. epilepsy, diabetes, etc.) - if there is no information please put 'None'.
Section E: Emergency Contact Details.
Emergency Contact One Full Name:*
Full Name Relationship to Member
Emergency Contact One Phone Number:*
Emergency Contact Two Full Name:*
Full Name Relationship to Member
Emergency Contact Two Phone Number:*
Medical Treatment Authorisation:*
- Yes
Please tick yes to give your consent to emergency treatment being given to the named member on this form by trained personnel, as it may be essential at some time for authorised persons acting on behalf of Bicester AC to have necessary authority to obtain urgent treatment which may be required whilst at representative club competition or training.
Do you give consent for a first aid trained coach to administer the EpiPen if the member is unable to do it themselves?
- Yes
- No
Do you give consent for a first aid trained coach to assist the member using their inhaler if the member is unable to do it themselves?
- Yes
- No
Authoriser's Name*
First Last
Date*
Day
Month
Year

Section F: Member's Agreement.
Agreement:*
- Yes
By selecting Yes I agree to abide by: 1: the codes of conduct relevant to my position within Bicester AC and agree to always behave in a manner befitting a Bicester AC member when attending training and club events. The clubs code of conduct can be found here www.bicesterac.co.uk/bac-club-information/codes-of-conduct/. 2: I agree that the club officials may take & publish photos (print / internet) of me for club promotional purposes. ( subject to the clubs safeguarding / photo policy which can be found here http://www.bicesterac.co.uk/bac-club-information/). If you do not wish for pictures to be taken of you please inform the membership secretary. 3. Data provide in this form will be stored and used in-line with Bicester AC's data protection policy.
Member's Name:*
First Last
Agreement Date:*
Day
Month
Year
Section G: Parent / Carer Agreement:
Agreement*
Please select appropriate. By selecting Yes I agree : 1. To the named athlete taking part in the activities of the club. 2. That I have read and agree to abide by the club code of conduct whenever I am present at club activities or competition, code of conducts can be found here www.bicesterac.co.uk/bac-club-information/codes-of-conduct/. 3. To helping at club events. 4. I agree that the club officials may take & publish photos (print / internet) of me / my child for club promotional purposes. (subject to the clubs safeguarding / photo policy which can be found here http://www.bicesterac.co.uk/bac-club-information/). If you do not wish for pictures to be taken of your child please inform the membership secretary. 5. Data provide in this form will be stored and used in-line with Bicester AC's data protection policy.
Parent / Carer's Name:
First Last
Agreement Date:
Day
Month
Year

Step 1 of 6

Bicester AC Membership Form 2026 - 27

Section A: Members Details.

Section B Parent / Carers Details

Section C: Parent/Carer/Existing Club Helper or Coach.

Section D: Medical Information.

Section E: Emergency Contact Details.

Section F: Member's Agreement.

Section G: Parent / Carer Agreement:

Section H: Membership Type and Payment.