Apply for IEKAC membership

If you would like to become a member of Invicta East Kent Athletic Club, please complete the form below and we will contact you.
  * required fields
 
First Name(s) *
Surname *
Known As if different from First Name
 
Gender *
Date of Birth * / /
 
Address *
 
 
Town/City *
County *
Postcode *
 
  Please provide at least one telephone number
Home Phone
Work Phone
Mobile Phone
 
Email Address *
 
Place of Birth
 
Next of Kin (Name) required if under 18
Next of Kin (Phone) required if under 18
 
Coach
 
  Please detail below any disability you have and/or any additional support you may require from our club coaches
 
Additional Support
 
  Please detail below any important medical information that our coaches/junior coordinator should be aware of (e.g. epilepsy, asthma, diabetes, allergies, etc.) Please do not leave blank - if there is no information please write 'None'.
 
Medical Notes
 
  By submitting this form, you consent to your special category personal data provided in section C and D to be shared with coaches for the purposes of the delivery of your safe participation in club activity. This data will not be shared or processed for any other purpose.

For membership applications for children under the age of 13, this consent must come from your parent.
 
Emergency Contact - Name *
Emergency Contact - Phone *
 
Invicta East Kent AC recognises the need to ensure the welfare and safety of all young people in athletics.

In accordance with the UK Athletics child protection policy and procedures, we will not permit photographs, video or other images of children/young people to be taken without the consent of the parents/carers and children/young people.

Invicta East Kent AC will take all possible steps to ensure these images are used solely for the purposes they are intended. If you become aware that these images are being used inappropriately you should inform the Club immediately.
 
Do you (or your parent/guardian if under 18) give permission for photos of you to be used for the purposes of publicising and promoting the club or sport, or as a coaching aid?
 
Select
 

Data Transfer to England Athletics

When you become a member of or renew your membership with Invicta East Kent AC you can also choose to be registered as a member of England Athletics (you will have to register with England Athletics if you ever compete for the club in competition Under UKA Rules). If you tick the box below we will provide England Athletics with your personal data which they will use to enable access to an online portal for you (called myAthletics). England Athletics will contact you to invite you to sign into and update your MyAthletics portal (which, amongst other things, allows you to set and amend your privacy settings). If you have any questions about the continuing privacy of your personal data when it is shared with England Athletics, please contact dataprotection@englandathletics.org.

If you do not tick the box below and then decide to compete for the club, we will need to register you with England Athletics and we will inform you at that time.
 
 

 

Club Privacy Statement & Communication Preferences

Invicta East Kent AC take the protection of the data that we hold about you as a member seriously and will do everything possible to ensure that data is collected, stored, processed, maintained, cleansed and retained in accordance with current and future UK data protection legislation.

Please read the full privacy notice carefully to see how The Club will treat the personal information that you provide to us. We will take reasonable care to keep your information secure and to prevent any unauthorised access.
 
  Under 18 Consent (to be completed by the parent/guardian of U18 applicant):
*
Parent/Guardian Name *
 

Athlete/Parent Agreement

By returning this completed form, I confirm that I have read and understood the privacy statement and how data will be used and shared and am willing to abide by the club code of conduct for athletes [and parents].
 
Date 15/12/2018