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• Title ^*
  - please select -MrMissMsMrsOther

  Please specify: ^*
• First name ^*

  Please provide your first name.
• Last name ^*

  Please provide your last name.
• Date of birth ^*

  Please provide your date of birth in the form 'dd-mm-yyyy', e.g. 21-04-1983
• Contact number ^*

  Please provide the best phone number to contact you on.
• Alternative contact number

  If you have an alternative contact number please provide it here,
• Home address ^*

  Please provide your full home address, including postcode.
• Emergency contact details ^*

  Please provide the full name and phone number of at least one person who can be contacted in the case of an emergency. This information will only be used in an emergency situation. You should advise your emergency contact that we have their details.
• Receive official club emails? ^*

  Please indicate whether you would like to receive official club emails with details of upcoming events/meets, club news, etc.

  Yes No
• Receive unofficial email from club members? ^*

  Please indicate whether you would like to receive unofficial emails from club members, e.g. requests for climbing partners, stuff for sale, etc.

  Yes No