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<p>&nbsp;</p>
<p class="header1">Become a member of Walking Stories</p>
<p>Fields marked with an <span class="asterisk">*</span> must be completed </p>
<p>N.B. Your address and contact details are necessary for administrative purposes.

The details you supply here will not be published or made available to third parties unless you indicate below (following the Personal Profile box)

See our Privacy Policy </p>

<form method="post" action="register_process.cfm" id="myform" name="myform" ENCTYPE="multipart/form-data" id="edit" name="edit">

<input type="hidden" name="UUID" value="E1C2BF7C-FEA0-52ED-5E0355269AB1DC22">

<table>
  <tr valign="top">
    <td class="bold">Name <span class="asterisk">*</span></td>
    <td><input name="member_name" type="Text" size="40" maxlength="100"></td>
  </tr>
  <tr valign="top">
    <td class="bold">Nickname (if different from name)</td>
    <td><input name="nickname" type="text" id="nickname" size="40" maxlength="100" /></td>
  </tr>
  <tr valign="top">
    <td class="bold">Use name? </td>
    <td> name
      <input name="use_name" type="radio" value="1" checked="checked" /> 
       nickname 
       <input name="use_name" type="radio" value="0" /></td>
  </tr>
  <tr valign="top">
    <td class="bold">Address <span class="asterisk">*</span></td>
    <td><input name="address1" type="text" id="address1" size="40" maxlength="100" /></td>
  </tr>
  <tr valign="top">
    <td class="bold">&nbsp;</td>
    <td><input name="address2" type="text" id="address2" size="40" maxlength="100" /></td>
  </tr>
  <tr valign="top">
    <td class="bold">&nbsp;</td>
    <td><input name="address3" type="text" id="address3" size="40" maxlength="100" /></td>
  </tr>
  <tr valign="top">
    <td class="bold">Postcode <span class="asterisk">*</span></td>
    <td><input name="postcode" type="text" id="postcode" size="40" maxlength="100" /></td>
  </tr>
  <tr valign="top">
    <td class="bold">Country <span class="asterisk">*</span></td>
    <td><input name="country" type="text" id="country" size="40" maxlength="100" /></td>
  </tr>
  <tr valign="top">
    <td  class="bold">Phone (day) </td>
    <td><input name="phone_day" type="Text" id="phone_day" size="40" maxlength="50"></td>
  </tr>
  <tr valign="top">
    <td  class="bold">Phone (evening) </td>
    <td><input name="phone_evening" type="text" id="phone_evening" size="40" maxlength="50" /></td>
  </tr>
  <tr valign="top">
    <td  class="bold">Email <span class="asterisk">*</span></td>
    <td><input name="email" type="Text" size="40" maxlength="100"></td>
  </tr>
    <tr valign="top">
    <td  class="bold">Password <span class="asterisk">*</span></td>
    <td><input name="password" type="Text" size="40" maxlength="100"></td>
  </tr>
  

  <tr valign="top">
    <td  class="bold">Club Member? </td>
    <td><select name="club_ID">
      <option value="">None</option>
	  
	  <option value="2">easywalkinggroup</option>
	  
	  <option value="3">Watendlath Ramblers</option>
	  
    </select></td>
  </tr>
  
    <tr valign="top">
    <td  class="bold">Profile Image</td>
    <td><input type="file" name="UploadFile1" size=35></td>
  </tr>
  
  <tr valign="top">
    <td   colspan="2"><p class="bold">Profile</p>
	<p>(optional - if you wish to have a page in the members' area of the site)      

Complete a few paragraphs about yourself - you may wish to include information on you and your family, your favourite walking areas, and any memorable experiences related to walking.</p>
	 <textarea name="comment" cols="70" rows="8"></textarea></td>
  </tr>
  
    <tr valign="top">
    <td  colspan="2">

<p>Please check this box if you do not wish your e-mail address to be shown on the site <INPUT name="show_email" type="checkbox" value="1" /></p>

<p>Please check this box if you do not wish to receive exciting e-mail updates about Walking Stores <INPUT name="receive_email" type="checkbox" value="1" /></p>

<p>Walking Stories may from time to time make members' details available to companies supplying products and services closely related to walking. We will not make these details available to unrelated businesses. Please check this box if you do not wish your membership details to be made available in this way  <INPUT name="share_details" type="checkbox" value="1" /></p> 

<p><b>How did you hear about Walking Stories?</b> <input name="how_heard" type="Text" size="40" maxlength="100"></p>
	

<p>I wish to become a member of Walking Stories, and agree to abide by the Terms and Conditions for Contributors.</p> 

<p>I understand that my membership may be terminated at any time by Walking Stories if I fail to do so.</p>
</td>
  </tr>
  <tr valign="top">
    <td colspan="2"><input type="submit" name="Submit" value="Register" class="submit" /></td>
    </tr>
</table>
<p>&nbsp;</p>

</form>

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    <area shape="poly" coords="5,13,33,8,55,5,58,22,58,31,36,37,33,50,18,39,5,27" href="story_continents.cfm/continent_ID/5/title/NorthAmerica" alt="North America" />
    <area shape="poly" coords="62,5,82,30,103,30,113,21,115,6" href="story_continents.cfm/continent_ID/4/title/Europe" alt="Europe" />
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  <tr valign="top">
    <td class="bold">Search:</td>
    <td><input name="criteria" type="Text" size="20" maxlength="100" Value="(enter search term)"></td>
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    <td colspan="2"><input type="submit" name="Submit" value="Search" class="submit" /> or click on map</td>
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