2024 FISS MEMBERSHIP REGISTRATION – INDIVIDUAL | Federation of Inline Speed Skating

Member Name(Required)

Please specify the Member’s first name and surname

Gender Identity

If you would like your gender or gender pronouns to be referred to differently than your birth sex specified above, for eg non-binary, please provide details here

Club(Required)

Please select your Club. If this does not apply to you, please select “independent”

Race Number(Required)

Please enter your race number. If you do not have one, please enter “0” and one will be assigned to you.

DATE OF BIRTH

Day(Required)

Please enter a number from 01 to 31.

Month(Required)

Please enter a number from 01 to 12.

Year(Required)

Please enter a number from 1900 to 2018.

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CurrentYear

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Age

CONTACT DETAILS

Name of Parent/Guardian(Required)

Please enter the name of the parent or guardian responsible for the Membership applicant

Email(Required)

Please enter a valid email address

Phone(Required)

Please enter a valid contact number

MEMBERSHIP TYPE

AGE CATEGORY

ADDITIONAL INFORMATION

Medical information

Please provide details of any allergies, medical conditions or disabilities/impairments here and any additional support which may be required. Please include any prescription medication if applicable

DATA CONSENT NOTICE

By submitting this form, you agree to the use of your data for the purposes of processing your registration and for the activities and records of the Federation of Inline Speed Skating. You agree to bide by the Federation’s rules, regulations and policies. Your data will be used and processed in accordance with Data protection and GDPR legislation. It will not be provided to third parties and remains confidential.

PAYMENT

Total

2024 FISS MEMBERSHIP REGISTRATION – INDIVIDUAL

2024 FISS Membership Registration – Individuals