If registering more than one person, please enter the name of the lead member first.
*
= Mandatory
*
Select
AG Walking Club - Family Membership GBP 15.00
AG Walking Club - Joint Member GBP 12.00
AG Walking Club Single Member GBP 8.00
MEMBER DETAILS
First name
*
Last name
*
Date of birth
*
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
Age
Address 1
*
Address 2
Address 3
Town
*
County
*
Post code
*
Home phone number
Mobile phone number
*
Email address
*
Verify email address
*
Please detail any medical information, allergies or injuries that the club should be aware of
*
Emergency contact name (1)
*
Emergency contact number (1)
*
Are you a qualified first aider?
*
Select
Yes
No
DECLARATIONS
*
I give consent for medical treatment to be administered
I do not give consent for medical treatment to be administered
TERMS AND CONDITIONS
*
I agree
Date added
ecfGradingDataUserInPSO
Is this you?
Account set-up not complete. Administrator – please ensure that you have selected how you would like to receive payment and who pays the transaction fees. Go to
Admin > Settings
to enter this information.
OK