YMCA Marathon Club :: Associate Membership

1) Title *

2) First name *

3) Last Name *

4) Occupation *

5) Date of Birth (DD/MM/YYYY) *

6) Age

7) Gender *

Male

Female

8) Residential Address (Include Postcode) *

9) Postal Address (if different from Residential)

10) Home phone

11) Work Phone

12) Mobile

13) Email *

14) Club Emails will be available from our website - www.ymcamarathon.org.nz. If you have no web access and a hard copy is required, please tick this box.

Hardcopy Required

15) PRIVACY ACT 1993 – The personal information provided in this form will be used by the Club for legitimate and reasonable Club related purposes only and in paying your membership fee you are taken to have consented to such use of your personal informat *

I do not want any image of me to appear on the website

I give permission for my image to appear on the website

16) The Club relies on its members to support the running of the club. Please indicate if you are willing to volunteer and assist in the running of any of the following Club activities

WhyWomenRun – Mother’s Day.

10K Series in the Domain – Thursday evenings during daylight saving.

Fundraising sub-committee.

Fundraising events – ad-hoc throughout the year.

Other that come up time to time.

17) Additionally, the Club is keen to explore new sponsorship opportunities, do you have own or work for a business that may be interested in providing sponsorship for the Club or it’s events?

Fees: The Auckland YMCA Marathon Club Inc. Annual Subs - $35.00 *

Payment Method *

Cash

Cheque

Direct Credit (account details on About Us page)

Signature (enter your name) *

Today's Date (DD/MM/YYYY) *

New Zealand's foremost marathon running and walking club

ASSOCIATE MEMBERSHIP