North East Masters Athletics Association Application Form
NORTH EAST MASTERS ATHLETICS ASSOCIATION (NEMAA) (Affiliated to North of England AA and BMAF)
APPLICATION FOR MEMBERSHIP. (updated 3 Apr 2017)
Membership Secretary: George Routledge 5 St.Hildas Avenue,Holy Cross, Wallsend,Tyne & Wear NE28 7AB
E-mail- NTMMNEVACSEC2013@HOTMAIL.CO.UK
The Association organizes masters athletics competition in the North East of England for men and women in five year age groups. Membership is confined to masters who either: (a) have bona fide residence in, or (b) were born within the counties of Northumberland, Durham, Tyne & Wear or Cleveland, and they must also be members of a UK Athletics-affiliated club.
The subscription for the calendar year 2017 is £20.00, however there was a £10 discount if members renew before 31st January. The fee for first time applicants is £10 throughout the year. Former members who wish to re-join NEMAA should send £20.00. Please complete the details below and return to the Membership Secretary (George Routledge) at the above address, with proof of date of birth (photocopy of passport,driving licence or birth certificate), your subscription fee and Stamped Addressed Envelope for your membership card.Cheques/PO’s should be payable to “ N.E.M.A.A ”. Please do not use this form for renewing subs.
NAME: ___________________________________________________ MALE/FEMALE*:__________
ADDRESS: ________________________________________________________________________
_______________________________________________________________ __________
POSTCODE: _______________ TELEPHONE NO. _______________________________
E.MAIL ADDRESS:(Print)________________________________________ _______________
DATE OF BIRTH: ______________________________________________________________
PLACE OF BIRTH: _____________________________________________________________
FIRST CLAIM CLUB: ____________________________________________________________
UK Athletics Registration No: _______________________
COPY OF I.D. included=_Passport *Driving Licence * Birth Certificate.
Volunteer Role Please indicate below any role in which you are willing to assist when not competing, with a note of any coaching qualifications you may hold:
Timekeeper …...... Track Judge …...… Starter …...... Field Judge …..... Marksman …….... Ancillary …....
I confirm that I am a member of a UK Athletics-affiliated club and that I reside in/was born within the NE Counties of England. I accept that my personal data and E mail address will be held on a computer by the Association., and will be used solely for the purposes of the Association and not disclosed to any third parties. I also accept / do not* accept that my E mail address may be given to BMAF in order for me to compete in BMAF events
Signature: …………………………………………… Date: ………………………Amount enclosed..£20 / £10 * delete* as applicable
