Membership application

New member fees for 2025 are:

Full Rate £49
Concessionary rates £40
Second Claim £30

Concessionary rates apply for First Claim Students, Unemployed and State Pensioners.
First claim fees include the registration charge levied by England Athletics. All fees include a Club vest or, for an additional £8, an official club T-shirt in lieu of a vest.

Note: To use the facilities at the Jaguar Sports and Social Club, eg toilets, showers, car park and the Social Club bar you must take out Social Club Membership, paying the additional fees as determined by the Jaguar Sports & Social Club.
Complete the form below and we will email you with payment instructions when we have received your application submission.

If you have a question, refer to the FAQ page of our website or contact us via the contact page.

Please note: This form is for new membership applications only. If you wish to renew your existing membership please refer to the Membership Renewal Page.
All fields are to be completed.
Title

First name

Last name

Postal address (house no/name and street

Town/City

Post code

Email address

Sex at birth
malefemale

Date of birth

Preferred phone number

Person to contact in case of emergency

(This is optional but if not given Club accepts no liability)

Name

Phone number

County of birth

(Counties are defined as pre-1974 boundaries (i.e. Warwickshire includes Coventry, Solihull and Birmingham)

If resident in Warwickshire (as defined above), have you had continuous bona fide residency for at least nine months? If not, state date of moving into the County.

YesNoN/A

Are you, or have you ever been, a member of another running club?
YesNo

Unique Registration Number
(This is your competition licence number on your EA Registration Card)

Is Northbrook to be your 1st or 2nd claim club?
(Unsure? see First claim/Second claim definition).
1st claim2nd claim

What First Claim class of membership are you applying for?

Full rate with vest £49Full rate with T-shirt £57Concessionary rate with vest £40Concessionary rate with T-shirt £48

What concession are you applying for?

State pensionerStudentUnemployed

You are applying for Second Claim membership

Standard rate with vest £30Standard rate with T-shirt £38

Please list any running qualifications, eg CIRF, LIRF

Your joining membership fee includes a club vest or club T-shirt

Please select below your preferred size.

XSSMLXLXXL

Please tell us why have you chosen to join Northbrook AC.

Terms of Membership

I have read and will abide by the Club Rules.
I agree to be bound by the UKA Anti-Doping Rules and agree to sign up to the Senior Athletes Code of Conduct.
I declare that I am an amateur, as defined by the Rules of the Governing Body of athletics.

Medical Declaration

I undertake to participate in any activities provided by Northbrook AC only if I am medically fit to do so. I participate in the Club's activities at my own risk and agree that Northbrook AC will not be held responsible for any injury, accident, loss or damage consequential to my participation.

Personal Data

By applying for membership I consent to my personal data provided on this form being held by Northbrook Athletic Club and used for the purposes of club membership management and communications and, if I am a first-claim member, my name, address, telephone number and date of birth being provided to England Athletics for competition registration and insurance purposes.
Learn more about how we process and protect personal data by reading our Privacy Policy.
Learn more about how our Athletics Governing Bodies process and protect personal data by reading their Privacy Statement

When all fields are completed select Submit once only and wait for the form to refresh.
You will receive an email confirmation and a further email with payment instructions when your application has been processed.