Join Us

Join Us Form

Name(Required)

First Last

Date of Birth(Required)

Email(Required)

Address(Required)

Street Address City County Postcode

Phone(Required)

Medical conditions (if any) Please enter ICE Contact name and number(Required)

Membership Type(Required)

Kit Size(Required)

Consent to any photo taken of them to be used by the club(Required)

Yes

I accept that I am participating at my own risk and that MKLR will bear no responsibility for any injury incurred(Required)

Yes

I confirm that I accept the UKA Code of Conduct relevant to my participation level with MKLR (beginner/senior athlete/coach/volunteer committee member/welfare oficer)(Required)

Yes

Phone

This field is for validation purposes and should be left unchanged.

Payments via Bank Transfer please:

Nat West

Sort Code: 60-01-16

Account: 45458413

Please put as reference : Name + subs