Newbury & Thatcham Hockey Club
Junior Section Membership Form
We are very pleased to welcome you to Newbury & Thatcham Hockey Club.
To ensure that we have the correct contact details for you, please complete the information requested below and return this form with your payment to the following address or at training:
Junior Coordinator, Newbury & Thatcham Hockey Club, Henwick Worthy Playing Fields, Henwick Lane, Thatcham, RG18 3BN
Junior members of Newbury & Thatcham Hockey Club are players below the age of 16 years old.
Junior Player’s Details
First name:...... Surname:......
Date of Birth:...... Gender:...... Male Female
Current school or college: ......
Does your school or college have a hockey team?Yes No
In order to help the club monitor its membership and to comply with Sport England equity requirements can you please tick one of the following boxes to identify your ethnic group:
White......
Mixed......
Asian or Asian British......
Black or Black British......
Chinese or other ethnic group......
Junior Player Medical Information
Please detail below any important medical information that our coaches/Junior Co-ordinator should be aware of (e.g epilepsy, asthma, diabetes, allergies etc.) and note the treatment or medication required.
......
......
Do you consider yourself to have a disability?...... Yes No
If yes, what is the nature of your disability (e.g. deaf, visually impaired, hearing impaired, physical disability, learning disability, multiple disability?
......
......
Arrival & Collection
Players who are 12 years old or younger (Sunday sessions) are expected to be dropped off and collected from the side of the pitch or inside the clubhouse. Players 13 years of age and older are regarded as being able to arrive and leave the training pitch or clubhouse unsupervised.
If you would like to propose an exceptional arrangement please mention it here:
......
......
First Parent/ Guardian Details
Forename of parent(s)/ guardian(s):......
Surname of parent(s)/ guardian(s):......
Relationship to junior member:......
Address:......
...... Post code:......
Home telephone: ...... ………………..
Mobile number:......
E-mail address: ......
Second Contact Person in Case of Emergency
Forename:...... Surname:......
Contact number(s):......
Relationship to junior member:......
The membership fee is £50 per season for first child, £25 per season for subsequent children from same family/household.
Cheques should be made payable to Newbury & Thatcham Hockey Club.
By returning this completed form, I agree to the young player for whom I am responsible taking part in the activities of the club including away fixtures. I understand that I will be kept informed of these activities – for example timing and transport details.
I have read the Code of Conduct for Parents and Guardians and agree to comply with it (available on demand or on the website –
At times the club may wish to take photos or videos of the team or individuals in it. We adhere to best practice guidelines to ensure these are safe and respectful and used solely for the purposes they are intended for, which is promotion and celebration of the activities of the club and training purposes.
I understand that in the event of any injury or illness all reasonable steps will be taken to contact me, and to deal with that injury/illness appropriately.
In the event of the club being unable to contact me, I give consent for the Coach, Club Welfare Officer or First Aid Officer to act on my behalf.
This information will be contained on a database for use by authorised club personnel only. We will also use this information to ensure that you are kept informed about club events. This information will also be used in the event of an emergency.
Signature of parent/guardian:...... Date:......
General Information (not mandatory but useful):
We find it helps our planning and organisation to know a few additional details about our parents/guardians. We would be grateful if you would answer the following:
Have you (parent/guardian) played hockey before?...... Yes / No
When and where did you play?
………………………………………………………………………………………………….
………………………………………………………………………………………………….
We may from time to time want to share your contact details with England Hockey and local sports partnerships. This is so you can be contacted with events and assessment sessions that may be of interest to you. If you would prefer not to be contacted directly by these bodies then please tick here _
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