Join Online - Juniors

In line with England Hockey guidelines players are considered to be Juniors if aged under 18 on 1st September 2016.

Before completing this form please ensure you have read the Worthing Hockey Club Membership Terms and Conditions.

Membership Rate: £60 (or £5 per month by standing order for 12m)
NB: Subscription amount includes a Gift Aid voluntary contribution element – details on request

Please pay by standing order or online bank transfer to Lloyds Bank, Sort code 30-99-93, Account no. 02100987, (please put ‘JR – your child’s name’ in the reference field)

or

cheques payable to ‘Worthing Hockey Club’

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Gift Aid: If you are a UK taxpayer Worthing Hockey Club can benefit by recovering tax on donations. Your personal tax position is unaffected. Please consider if you can help to support the Club in this way.

* – indicates mandatory field

Personal Details

Full Name *

Contact Email *

Date of Birth *

Address *

Contact Phone No. *

Emergency Contact Name *

Emergency Contact Phone No. *

School *

Please state any coaching or umpiring qualifications held

Medical Information

In case of emergency, and as part of the Worthing Hockey Club responsibility to it's membership, junior members are required to complete this medical information form as accurately as possible.

Details will be held securely with access restricted to authorised officers only.

Please use this space to provide details of any medical information or disabilities that you feel should be brought to the attention of the managers and coaching staff.

Medical Declaration: I consider my son/daughter to be physically fit and capable of full participation and agree to notify Worthing Hockey Club of any changes to the medical information provided. Furthermore, in the event of injury I give my permission for the team managers/coaches appointed by Worthing Hockey Club to obtain emergency medical treatment for my son/daughter *.

Parental Consents *

Media Consent: I consent to Worthing Hockey Club photographing or videoing my child’s involvement in hockey and to his/her name and/or Club name being published with any photograph in authorised Club/Event publications, Press articles and our website.

I consentI do not consent

Changing Policy: (See membership terms and conditions.)

My child will change at homeMy child can change at the clubMy child can only change under supervision

Declaration: I agree that my son/daughter participate in the club’s activities entirely at my own risk and that they must play in a manner that is safe for themselves and others. I have read and understood the rules of the Club and the Conditions of Membership and agree to abide by them. Worthing Hockey Club has adopted the EHB ‘Safeguarding & Protecting young people in Hockey’ and the ‘Code of Ethics & Behaviour’ policies. By submitting this membership form you also agree to abide by these policies.

Other Information

As part of our affiliation to England Hockey we are required to provide statistics on our membership. This section is not compulsory. All data submitted to EH is summarised and anonymous - individual responses are not disclosed and individuals are not identifiable.

Payment

Junior Membership - £60

Members of Worthing Hockey Club are deemed to be junior members if they are under 18 years of age on the 1st September 2016 (in line with EH guidelines). Age groups for subscriptions and tournaments are based on age on the 1st September 2016.

Payment Method:

I will set up a standing orderI will pay by bank transferI will post a chequeI will pay cash

Gift Aid: If you are a UK taxpayer and would like to know more about how you could help the club through the Gift Aid scheme please check this box; you will then be sent more information and a simple form to complete. Please consider if you can help support the Club in this way.

Gift Aid

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Note: You will not be able to submit the form if you have unchecked any of the declaration boxes.