WINTER LEAGUE2016- 2017 - ENTRY FORM

Name of Club

England Netball Affiliation Number

Caps Accreditation Date or Date Registered

Name and Address of First Contact

(including Post Code)

Mobile Tel. No. of Contact

Email Address:

Name of Second Contact

Mobile Tel. No. of Second Contact

Email Address:

Name of Safeguarding Officer

Mobile Tel. No.

Email Address:

Registered Playing Colours

(a) Dress or Skirt

(b) Shirts

(c) Bibs

Commencement of WinterLeague will be Saturday 17thSeptember 2016 (depending on entries)

Entry Fee:£100.00 for CurrentTeams £120.00 New Teams £70.00 for teams who played in the Winter League 2015-2016

SNA Affiliation£10.00 per team

£15.00 if affiliated outside of Southampton

Entry Form must be returned electronically to NO LATER THAN FRIDAY, 12th AUGUST, 2016, NO LATE ENTRIES ACCEPTED

Entry fee and Affiliation to SNA must be received via bank transfer using the club name as the reference NO LATER THAN FRIDAY, 12th AUGUST, 2016 . This must be followed by an email to confirm payment

Bank: HSBCAccount Name: SNAAccount No:61330888Sort Code 40-42-22

Player, Umpire and Coach Registration must be received electronically NO LATER THAN FRIDAY, 26th

AUGUST, 2016

ALL CLUB MEMBERS MUST BE AFFILIATED TO ENGLAND NETBALL SR HNA AND SNA.

TO ENTER THE LEAGUE ALL CLUBS WILL HAVE A SAFEGUARDING OFFICER AND CLUBS MUST IMMEDIATELY INFORM THE COMMITTEE OF ANY CHANGES. ANY TEAM WITH MEMBERS UNDER THE AGE OF 18 MUST HOLD CAPS ACCREDITATION OR BE REGISTERED AND ACTIVELY WORKING TOWARDS THIS AND ACHEIVING MIMIMUM OF BRONZE ACCREDITATION WITHIN TWO YEARS OF REGISTRATION

DECLARATION

BY SIGNING THIS FORM AS THE REPRESENTATIVE OF THE CLUB:

All members have read and agreed to abide by the Conditions of Entry and Codes of Conduct for ‘Players’, ‘Umpires’, ‘Coaches’, ‘Spectators’ and ‘Parents, Carers and Supporters’. The Accident & Injury Reporting Procedures and England Netball Disciplinary and Grievance Procedures as adopted by Southampton Netball Association WILL be adhered too.

All members are aware that SNA reserve the right to refuse entry to any member, club or team

Name of Representative

Signature of Representative

Date Signed

REGISTRATION OF PLAYERS

BY SIGNING THIS FORM YOU AGREE TO THE DECLARATION SIGNED BY THE CLUB REPRESENTATIVE

Name of Player / Affiliation No. / Signature of Player / D.O.B. (if under 18)

NAME OF TEAM

DIVISION

To be returned NO LATER THAN FRIDAY, 26th AUGUST, 2016

Electronically to

REGISTRATION OF OFFICIALS and COACHES

BY SIGNING THIS FORM YOU AGREE TO THE DECLARATION SIGNED BY THE CLUB REPRESENTATIVE

Name of Official
Umpire and / or Coach / Umpire Level / Coach Level / Email Address / Contact Telephone No.

NAME OF CLUB

To be returned NO LATER THAN FRIDAY, 26th AUGUST, 2016

:

Electronically to