Erskine Stewart’s Melville Youth Hockey Club – Easter 2018

Athletes Name: enter full name here

Athletes DOB:DOB

Current year group : year group last attended

School:enter school name

Hockey Club:enter hockey club

Parent/Guardian Name:Parent/Guardian name

Contact number: Tel. No.

Email address: email

Camp selection

Full Week / Mon / Tue / Wed / Thurs / Fri
1 / 2nd-6th Apr / 9am-1pm / general skills P6-P7 / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ /
2 / 2nd-6th Apr / 2pm-4pm / Advanced skills S1-S6 / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ /
3 / 9th-13th Apr / 9am-1pm / General skills S1-S3 / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ /
4 / 9th-13th Apr / 2pm-4pm / Advanced skills
S1-S6 / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ /

Any medical conditions/allergies (including current medication);

Enter detail here

Price

£100 per camp per week

Or £30 per session per day

Discounted price if booking multiple camps or for siblings

£90 per camp per week

(discount only applies to weekly rates)

All Completed Applications must be submitted by email to:

CONSENT (please read carefully)

I agree to my son/daughter taking part in the ESM HC Camps

a)I confirm to the best of my knowledge that my son / daughter does not suffer from any medical condition other than those listed above

b)I understand that the Club or Organisers accept no responsibility for loss, damage or injury caused by or during attendance at the Camps except where such loss, damage or injury can be shown to result directly from the negligence of the Club or the Organisers

c)I consent to my son / daughter being photographed and/or filmed for Club purposes

Click to consent.

Once the application form has been received we will send payment instructions via email