Highvale Netball Club Inc.Registration Form – NEW PLAYER
Dear Parent/Player,Welcome to the Highvale Netball Club. We hope that you or your daughter enjoys their time with us. To ensure we can accurately register you or your daughter with the Waverley City Netball Association and correctly provide player details; please complete the following registration form details and return to your coach or a committee member. Page 2 is a payment reminder and we ask that all fees, as indicated are paid on the due date.
Kind Regards,
Greg Hunt
Highvale Netball Club President.
Players Name
Address / Date of Birth
Telephone No. / Mobile No. / E-mail:
Parents
VNA No. / WCNA No.
School
I am interested in / UmpiringYesNo / CoachingYesNo
May we display the player’s photo for club promotion purposes? No names will be included. Yes No
Privacy Policy: The Highvale Netball Club collects information from our members on the registration form at the beginning of each season. This information will be collected for the sole use of the Club. Highvale Netball Club does not offer or allow the selling of any user-provided information to third parties unless you first provide us with your consent to do so. If you have any questions regarding our Privacy Policy or wish to receive a copy of Highvale Netball Club’s policy please contact one of the current committee members.
PERSONAL AND MEDICAL INFORMATION (Supply of this informationis voluntary)
I hereby consent to the provision of the following health information for Highvale Netball Club records. They are to be used in the event of injury, illness or emergency, if required. Your details will only be disclosed to the following club officials: all members of the Highvale Netball Club committee and relevant coaches. You will be able to access your personal information through the club secretary.
Medicare No: / Ambulance Member No:Private Health Insurance Company: / Membership No
Existing Medical Conditions: / Past Injuries:
Allergies: / Regular Medication:
Emergency contact (1): / Phone Nos.
Emergency contact (2): / Phone Nos.
CONSENT: I understand that Highvale Netball Club and Waverley City Netball Association will play the Waverley City Netball competition under the rules as set in accordance with Netball Victoria guidelines. I also understand that netball is a limited contact sport and that there is a risk of injury involved in playing netball. I authorise any official from Highvale Netball Club overseeing the Winter or Spring 2016 netball competition with Waverley City Netball Association, in the event of any injury or illness, and failing to be able to contact either of the emergency contacts,to obtain on my behalf and at my expense any medical assistance, treatment and transportation as deemed necessary.
INDEMNITY: Except where provided or required by law and such cannot be excluded, I agree that Highvale Netball Club and Waverley City Netball Association and its respective directors, officers, members, servants, or agents are absolved from all liability however arising from injury or damage to player. However caused, arising whilst participating in the netball competitions with Waverley City Netball Association.
I have read, understood and agree to the above terms. I warrant that all information provided is true and correct.
By submitting this application and paying fees, I agree to be bound by the rules of the Highvale Netball Club Inc.
Signed (parent/legal guardian or player if over 18years): ......
Date......
HIGHVALE NETBALL CLUB – FEE PAYMENT DETAILSFees – As advised by the committee:
Club and WCNA fees / VNA / Total (Club + VNA)$______
Payment options
By cheque / Cash / Bank transferMake cheques payable to: Highvale Netball Club
Mail cheque with this form to:
Marion Hoskin
21 Daintree Grove Narre Warren 3805Alternatively, pass on to acommittee person, Team Manager or Coach. / Place cash and this form in an envelope and give it to a committee person, Team Manager or Coach. / Electronic transfer to: Comm Bank
BSB: 063 182
Account no.: 009 021 71
Account name: HNC Inc.
Include the player’s last name and first initial in the reference field
Committee Members
President Greg Hunt 0418 312 100
/Secretary Eliza De Cesare 0421 516 542
Vice PresidentNicole Newey 0403327168
/Treasurer Marion Hoskin 0409 213 518
CoachingDonna Stevens 0408 126 018
/MembershipGreg Hunt 0418 312 100
UniformsFiona Bahr(u11/13) 0425 868 898
Linda Hallcroft (Seniors )0438512 897
/UmpiringLinda Hallcroft0438512 897
/Website
Saturday Game Day, Jells Park, Corner Waverley & Jells Roads, Glen Waverley
Wednesday Training, Under 11s and 13s – 5PM to 6PM, Under 15s and 17s 6PM to 7PM at
Sportlink, 2 Hanover Road, Vermont South (Behind Vermont South Shopping Centre on Burwood Highway)