Join the Training Payment Scheme

Company

Training Payment Scheme Application (Aged 18+ Only)

Please make sure you complete both parts below

Part One: Please complete the form below.

Part Two: Complete a direct debit mandate at GoCardless.com, click here

We will use this information to ensure that you are kept informed about important information relating to the scheme.

Athlete First Name *

Athlete Last Name *

Email Address *

ICE Contact Name *

Please enter an incase of emergency contact name

ICE Contact Number *

Please enter an incase of emergency contact number

Parkrun Barcode *

No Yes Would you like to register your park run number as your BBD membership number?

Park Run Barcode Number *

Please enter your park run barcode number

Email Updates *

No Yes Would you like to receive email updates?

Photo ID

No Yes Would you like to have a photograph on your membership card?

Photo Upload

The size of your photos must: measure 45 millimetres ( mm ) high by 35mm wide which is standard UK passport size, the file format must be JPG or JPEG

GDPR Consent to Data Collection?

Personally identifying information that is entered into this form, including names and email addresses will be stored on the Bungay Black Dogs Running Club website until GoCardless has confirmed the direct debit mandate has been successfully setup.

Policy Information *

GDPR Consent to Data Collection ?

Personally identifying information that is entered into this form, including names and email addresses will be stored on the Bungay Black Dogs Running Club own MS Access written database software whilst part of this scheme.

Policy Information *

Please Confirm You Are Aged 18 Years or Over? *

No Yes Athletes under 18 years of age are not currently able to join the scheme.

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