FOUNDED 1925
CLUB ROOMS: CHINGFORD PARK, NORTH EAST VALLEY, DUNEDIN, NEW ZEALAND
| FAMILY NAME: | GIVEN NAME: | |
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ADDRESS:
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| DATE OF BIRTH: (required for runners only - for age grades) |
MALE/FEMALE: | NEW MEMBER: YES/NO |
| RUNNER: | WALKER: | SOCIAL: |
| PHONE WORK: | PHONE HOME: | CELLPHONE: |
| EMAIL: | PART OF FAMILY APPLICATION: YES/NO | NUMBER OF FAMILY MEMBERS IN APPLICATION: |
All address and personal details are for the registration of the club member and will only be divulged to elected members of the general club committee and will not be used for any purposes such as advertising or for any such similar purposes. Date of Birth and Gender is required for grading of runners who compete in club and/or centre and national events - applies to social runners too.
Payment details for registration:
Note: The treasurer will reply to the prospective member's application and
send an invoice with payment details which will depend on the criteria explained
immediately below. Payments will differ per application depending on family
membership, grade, employment/student circumstances and other considerations.
Payments can be arranged on a weekly or monthly basis on request to the treasurer.
If you are applying for a family discount please indicate above. For further
information and queries about payments contact the treasurer Greg Johnston:
Phone 4876100 (after hours) or email jillgreg@actrix.co.nz
FULL REGISTRATION (includes Athletics Otago/Athletics New Zealand registration
+ club subscription)
Seniors & Masters $120
Students/Beneficiaries $85
19 and under $60
16 and under $50
14 and under $45
12 and under $45
SOCIAL REGISTRATION (includes only the club subscription and not registration
with Athletics New Zealand)
Social Runners $40 (eligible
for all Leith club events, including Poneydales and Otago University Lovelock
Relays. Also includes selected Open Athletics Otago races with entry fee to
be paid on race day)
Recreational Walkers $20
FAMILY DISCOUNT
Family discount
- Family of three or more (minimum of one adult) = 15% discount
Those who join for the summer season will only be required to pay the Athletics
Otago Centre fee (see treasurer for amount).
FULL REGISTRATION COVERS THE ENTRY FEES TO ALL ATHLETICS OTAGO WINTER RACES
If you are sending payment with this application and if paying by cheque, then please make out cheque to " Leith Harrier and Athletic Club Inc." and send to: The Treasurer, Leith Harriers, PO Box 1507, Dunedin, along with this membership application form.