Club Membership

2017 Club Membership

The 2017 Membership online form is now available. To adhere to data protection, welfare and club governance it is important that all club athletes, coaches and volunteers register. To ensure the data accurately reflects each club member a separate submission will be required for each person. Specific information and acceptance will be required for every U18 club member.

Payments are to be made by BACS to the City of York AC (details included in the form). Where no BACS transfer facility is available then cheques are accepted. If you have any questions then please email membersec.coyac@hotmail.co.uk,

Contact details:

Forename (required):*
Surname (required):*
Date of Birth - dd/mm/yyyy (required)*
Male / Female (required):*
Contact Number - UK landline / mobile if 16 or over*
Alternative Contact Number :
E-mail:
Address (required):*

Emergency Contact Details (required)

Emergency Contact Name (I.C.E):*
Emergency Contact Number :*
England Athletics number (if known)

Medical Information (required)
Please indicate any medical condition, medication or disabilities the club should be aware of:

Medical information (required):*
Medical / disability summary:

Membership and Payment Details
Please select the membership type relevant to your application. The cost will need to be reflected in the payment field.

Family Membership
Please note that family memberships comprise of no more than 2 competing athletes. Additional competing family members can be submitted with a charge of £14. If opting for this membership option then it is important to include a family ID that will link your family group. For example "smith1234". You will still be required to submit a separate form for each family member.

Family ID:
Total family membership payment due (£):

Individual Memberships

Total payment due (£):

Payment Details
All Payments To Be Made By BACS Please. Payments to be paid online to City of York AC
Please give your surname as reference and also put the date & amount of online payment.
Sort Code: 40 – 47 – 31
Account Number: 41238965

Date of payment: (dd/mm/yyyy)
Amount Paid (£):

New members only
It is important to us to know how you found out about the Club or decided to join us. Please select accordingly:

New members

Are you a current member of another athletic club, or were you a member of another athletic club last year?  If so, please fill in the details below:

What will City of York AC status be i.e. First/Second Claim?
What is the name of the other club of which you are a member?
If you have recently left another athletic club, what was the date of your resignation?

Training Offsite (required)
All U14 athletes are to remain in the appropriate facility. Athletes aged 14 to 17 are permitted to train or warm up outside of the facility if supervised by a coach or an adult athlete 18 year of age or over. Please indicate your preference by selecting one of the below options:

Offsite training (required)*

Travel/Photographs
Authorised photographers may be used on occasion by the club to take pictures of members taking part in events for publicity and promotional purposes (e.g. club newsletters/ website/local newspaper). If you do not agree to your child’s photograph being taken for such purposes please indicate below:          

I give permission for this member who is under 18, to travel on transportation arranged by the club to events or training sessions away from the track.

Photography permission - under 18 (required)*
Travel permission - under 18 (required):*
By submitting this application:
- I confirm that the information given is correct.
- It is my responsibility (or my parent or guardian if under 18) to inform my coach of any medical condition or disability.
- I have read and agree to be bound by the Club rules, Code of Conduct and equity statement. Copies are available online or from the enquiries.coyac@hotmail.co.uk on request.
- I understand that in the event of injury or illness all reasonable steps will be taken to contact my next of kin (as provided in 'ICE' details), and that my injury/illness will be dealt with appropriately.
- I note that the club accepts no responsibility for the health or well-being of any member as a result of physical exercise, notwithstanding that the state of health has been declared in this application.
- I confirm that I am eligible to compete under GB Athletics Rules.

Data Protection
- I understand that my personal data will be held securely by the club.
- I agree to the use of my personal data for internal club administration and England Athletics (or any authority that may supersede it).
- All these bodies are registered under the Data Protection Act 1998.

Comments are closed.