Club Registration Form

CLUB REGISTRATION FORM

Name:
Address:
D.O.B
Age:
Email Address:
Telephone (Home):
Telephone (Mobile):
Medical Conditions:
(eg Asthma)
Name of GP:
Address of Surgery:
Emergency Contact
Name:
Emergency Contact
Number:
UNDER 18S
As parent/guardian for the above named, I permit Priorians Hockey Club to take photos for promotional purposes and for use on the Club’s Website and Videos for use as a training aid.
In the event of Illness, having parental responsibility for this child, i give permission for medical treatment to be administered by a nominated first aider, if I cannot be contacted and my child requires emergency hospital treatment, I authorise a qualified medical practitioner to provide emergency treatment and/or medication including anaesthetics.
Signed: / Date:
Print Name: / Relationship to child:

Type of membership:Tick:

Senior (15 yrs+) Fees:

£160 Full Playing Member
£100 School/Student/Unemployed Player
£3 Non-competitive player (training only)
Colts (11-14yrs) Fees:
(£10 Season Membership /£2 Per Training Session)
Minis (6-10 yrs) Fees:
(£5 Season Membership /£2 Per Training Session)
Terms and Conditions:
Fees cover the cost of insuring you as a player whilst being a member of the club. They also contribute to the hire of the pitches throughout the season.
Fees do not cover the cost of coaching as this is completed on a voluntary basis. Only the senior coaches are compensated for expenses.
As a member of the club you are invited to attend all open committee meetings which are held.
By signing this agreement I agree to abide by Club Policies and Procedures and follow all rules set down by the club and the committee with regard to running Priorians Hockey Club.
Signed: / Date:

The club needs your help!

Priorians Hockey Club are always on the lookout for more volunteers, with ever increasing numbers the demands on our coaches and helpers increases each year. We can always use extra hands to help us run our mini and colts section of the club. If you feel you can help in any way please indicate below how below: (please circle)

The signing in/out process at training / Yes/No
Assisting coaches during training / Yes/No / NOTE OF FEES PAID:
Administration work / Yes/No
Accompanying children on away trips / Yes/No
Learning to umpire children’s matches / Yes/No
Organising and supporting social event / Yes/No