Please complete the form below in order to join Chippenham Tristars:

Membership cost

Participant / Member Details

Name

Gender

Age

Date of birth

Parent/Guardian and Emergency contact

Name

Address

Email

Phone

Other emergency contact details

Medical and Specific Needs

Please give brief details of any medical or health conditions that might affect your participation in triathlon and indicate if you would like to discuss support/modifications you may require

Athlete Objectives

Swim: You should be able to swim at least 50m. Please indicate if you/the young athlete is a member of a swim club

Cycling: Your bike should be in good condition and road worthy at all times. Please indicate if you/the young athlete has done any cycle races/events

Running: Please indicate if the young athlete has done any run races/events

What are the young athlete's objectives for this/next triathlon season?

What are you hoping to achieve from Chippenham Tristars training sessions or membership?

I consent to the young athlete being photographed for club promotional purposes

I give permission for my son/daughter to participate in triathlon coached sessions under the instruction of a qualified coach.
I understand and agree that my son/daughter participates in coached sessions entirely at his/her own risk.
I am satisfied that my son/daughter is sufficiently responsible and competent to assume full responsibility for his/her own safety under the supervision of a qualified coach.
I consent to my child receiving basic First Aid treatment if necessary.
I understand that should my son/daughter have particular needs requiring additional support I may be asked to be present at coached sessions. I understand that my son/daughter is expected to follow the Chippenham Tri ‘Code of Conduct’ and if s/he does not, s/he may be asked to leave the session, and possibly not allowed to return.

I understand Chippenham Tri's Privacy Statement: In becoming a member of Chippenham Triathlon Club (CTC), CTC will collect certain information about you which will include your name, date of birth, gender, BTF number, email address, address, telephone number, medical/specific needs you feel we should be aware of, any requirements for assistance to participate in triathlon, and the name, address and telephone number of your emergency contact person. CTC will collect and process your Triathlon Data for the purposes of registering you as a member of CTC and administering your involvement in the club. We will process it on the basis for the interests of registering you as a member and to administer the club. Please see the Club’s Privacy Policy for a full explanation.