Join Crusaders AC

Print out the following form and send it in with the appropriate membership fee to :

The Treasurer Crusaders AC
Irishtown Stadium,
Irishtown,
Dublin 4

If signing up for family membership please list names of all family members.




Name(s) : ___________________________________________________________________________________




Address : ___________________________________________________________________________________




_____________________________________________________________________________________________




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Home phone : ________________________________________________________________________________




Work phone : ________________________________________________________________________________




Mobile : ____________________________________________________________________________________




Email : _____________________________________________________________________________________
By entering an email address above I agree that it may be entered into a club database for the 
sole purpose of official club communications and for AAI Registrations.




Date of Birth : _____________________________________________________________________________




County / Country of Birth : _________________________________________________________________




Event of interest & Previous bests if applicable 




_____________________________________________________________________________________________




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If you have been registered with another Irish club in the past 3 years please state which 
club and the year here.




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If the proposed member is under the age of 18 the signature of a parent or guardian is required.
(If you wish no photographs of your child to be published by Crusaders AC for any purpose please
indicate so here by circling OPT-OUT)



                                                                                  OPT-OUT
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Please Circle below; 
I enclose the appropriate fee for 
Senior (85) / Junior (40) / Student (45) / Patron (20 or nominative) / Family Membership (140)